Simonato Lorenzo, Baldi Ileana, Balzi Daniela, Barchielli Alessandro, Battistella Giuseppe, Canova Cristina, Cesaroni Giulia, Corrao Giovanni, Collini Francesca, Conti Susanna, Costa Giuseppe, Demaria Moreno, Fornari Carla, Faustini Annunziata, Galassi Claudia, Gnavi Roberto, Inio Andrea, Madotto Fabiana, Migliore Enrica, Minelli Giada, Pellizzari Michele, Protti Mariangela, Romanelli Anna, Russo Antonio, Saugo Mario, Tancioni Valeria, Tessari Roberta, Vianello Alice, Vigotti Maria Angela
Dipartimento di medicina ambientale e sanità pubblica, Università di Padova.
Epidemiol Prev. 2008 May-Jun;32(3 Suppl):5-14.
The availability of Electronic Health Archives (EHA) has increased remarkably over the last twenty years. As part of a joint project of the Italian Association of Epidemiology (AIE) and the Italian Association of Medical Statistics and Clinical Epidemiology (SISMEC), a workgroup of experts was set up in 2005 with the aim of comparing various experiences and of standardizing the procedures by which electronic sources can be integrated. In particular, the workgroup's aim was to estimate the frequency of certain major diseases using standard algorithms applied to EHA. This volume is published with the purpose of making available in a common publication the methods and the results obtained. The results from a multicentre study using a standard approach to probabilistic record-linkage procedures are also included in a specific chapter. Eleven Italian centres from five Italian regions with an overall population of 11,932,026 collected and treated more than 21,374,426 records (year 2003) from five electronic information sources: death certificates, hospital discharge records (including outpatient discharges), drug prescriptions, tax- exemptions, and pathology records in order to estimate the frequency of the following diseases: diabetes, ischemic heart diseases, acute myocardial infarction, stroke, asthma, chronic obstructive pulmonary disease, obstructive lung diseases. For each pathology a specific algorithm was developed and used by all centres for the identification of the prevalent/incident cases of the selected diseases. Standardized methods were used to estimate the rates. The results confirm the need for a common standard approach to produce estimates based on EHA, considering the variability of the quality and of the completeness of the archives, and the difficulties of standardizing record-linkage operations in the various centres. The main achievement of this work was the elimination of the variability due to the use of different algorithms to identify cases using EHA.
在过去二十年中，电子健康档案（EHA）的可用性显著提高。作为意大利流行病学协会（AIE）和意大利医学统计学与临床流行病学协会（SISMEC）联合项目的一部分，2005年成立了一个专家工作组，旨在比较各种经验并规范电子数据源整合的程序。特别是，该工作组的目标是使用应用于EHA的标准算法来估计某些主要疾病的发病率。本卷出版的目的是将所获得的方法和结果在一份共同出版物中呈现。使用标准概率记录链接程序方法的多中心研究结果也包含在特定章节中。来自意大利五个地区的11个中心，总人口为11,932,026，从五个电子信息源收集并处理了超过21,374,426条记录（2003年），这五个电子信息源分别是：死亡证明、医院出院记录（包括门诊出院记录）、药物处方、免税记录和病理记录，以估计以下疾病的发病率：糖尿病、缺血性心脏病、急性心肌梗死、中风、哮喘、慢性阻塞性肺疾病、阻塞性肺病。针对每种疾病开发了一种特定算法，并由所有中心用于识别所选疾病的流行/发病病例。使用标准化方法来估计发病率。结果证实，考虑到档案质量和完整性的变异性以及各中心记录链接操作标准化的困难，需要一种通用的标准方法来基于EHA进行估计。这项工作的主要成果是消除了因使用不同算法通过EHA识别病例而产生的变异性。
