在患有饮食障碍的儿科患者中使用行政数据确定肠道营养:一项开发和验证研究
Carly E Milliren1, Olivia Eldredge2, Elana M Bern2,3
1Biostatistics and Research Design Center, Boston Children's Hospital, Boston, Massachusetts, USA.
JPEN. Journal of parenteral and enteral nutrition
|September 25, 2025
概括
行政数据可能低估了饮食障碍患者的肠道营养 (EN) 使用情况. 虽然特异性很高,但EN使用仅在16.2%的病例中通过计费数据被确定,而通过医疗记录只有30.0%.
科学领域:
- 医疗保健管理部门的管理.
- 临床营养学 临床营养学
- 儿科健康 儿科健康
背景情况:
- 肠道营养 (EN) 是患有饮食障碍的患者的关键干预措施.
- 缺乏用于捕获EN行政数据的验证方法.
- 这项研究解决了对该人口中EN使用的准确数据的需求.
研究的目的:
- 评估行政计费数据的准确性,以确定住院饮食障碍患者的EN使用情况.
- 使用儿科健康信息系统 (PHIS) 进行EN识别,并与临床文档进行比较.
- 评估EN跟踪的行政数据的性能指标.
主要方法:
- 使用的PHIS计费数据 (2018-2022) 对9-20岁的饮食障碍患者.
- 使用ICD-10程序和临床服务和供应的CPT代码识别EN.
- 验证的PHIS数据与医疗记录审查相对应,计算灵敏度,特异性,准确性和kappa.
主要成果:
- 包括483次住院;PHIS数据在16.2%的病例中发现EN,而在医疗记录中为30.0%.
- 总体准确率为85.3%,具有高特异性 (99.4%) 和积极的预测值 (97.4%).
- 观察到适度的协议 (kappa=0.60),这表明行政数据可能低估了.
结论:
- 行政数据可能低估了饮食障碍患者的EN使用情况.
- 高特异性和积极的预测值表明在记录EN时可靠的识别.
- 这些发现对于使用行政数据来量化EN使用和低估的卫生服务研究至关重要.
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