电子案例报告的实用性用于德克萨斯州的病例识别出生缺陷监视监控
R P Allred1, C Yantz1, H Jeon1
1Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA.
Birth defects research
|December 10, 2025
概括
电子病例报告 (eCR) 显示了早期出生缺陷病例识别和社会服务转介的潜力. 然而,与电子健康记录 (EHR) 相比,当前的eCR数据是不完整的,缺乏标准化.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 电子病例报告 (eCR) 对出生缺陷监测的有效性在很大程度上仍未得到审查.
- 本研究评估了电子初始病例报告 (eICR) 作为病例识别来源的潜力,并将其数据完整性与电子健康记录 (EHR) 相比较.
研究的目的:
- 评估eCR在出生缺陷监测中的实用性.
- 为了比较eICR与EHR捕获的人口和诊断信息.
主要方法:
- 从德克萨斯州出生缺陷登记处的eCR数据流中确定了出生缺陷病例.
- 来自eICR和随后抽象的EHR的数据进行了完整性和一致性的比较.
- 使用加权的kappa统计数据来评估两个数据源对各种变量之间的一致性.
主要成果:
- 与电子健康记录相比,eICR表现出严重的数据缺陷,报告的出生缺陷和手术较少.
- 对于大多数变量,eICR和EHR之间的一致性很低,但有明显的例外,包括婴儿的性别,出生日期和初级缺陷诊断.
- 对于婴儿的性别 (kappa=0.95),出生日期 (kappa=0.99) 和初级缺陷代码 (kappa=0.83-0.92) 观察到高度一致.
结论:
- eCR提供了一种潜在的途径,可以及时识别潜在的出生缺陷病例,并促进迅速的社会服务转介.
- 标准化问题和eCR数据文件中缺少的关键变量限制了它们对风险因素分析的全面性.
- 虽然对初始病例识别有希望,但eCR尚未成为对出生缺陷监测所有方面的全面数据资源.
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