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牙科临床研究中电子患者数据的再利用:现状综述

Reusing electronic patient data for dental clinical research: a review of current status.

作者信息

Song Mei, Liu Kaihong, Abromitis Rebecca, Schleyer Titus L

机构信息

Center for Dental Informatics, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261, United States.

出版信息

J Dent. 2013 Dec;41(12):1148-63. doi: 10.1016/j.jdent.2013.04.006. Epub 2013 Apr 18.

Abstract

OBJECTIVES

The reuse of electronic patient data collected during clinical care has received increased attention as a way to increase our evidence base. The purpose of this paper was to review studies reusing electronic patient data for dental research.

DATA SOURCES

1527 citations obtained by searching MEDLINE and Embase databases, hand-searching seven dental and informatics journals, and snowball sampling.

STUDY SELECTION

We included studies reusing electronic patient data for research on dental and craniofacial topics, alone or in combination with medical conditions, medications and outcomes. Studies using administrative or research databases and systematic reviews were excluded. Three reviewers extracted data independently and performed analysis jointly

RESULTS

The 60 studies reviewed covered epidemiological (32 studies), outcomes (16), health services research (10) and other (2) topics; were primarily retrospective (58 studies); varied significantly in sample size (9-153,619 patients) and follow-up period (1-12 years); often drew on other data sources in addition to electronic ones (25); but rarely tapped electronic dental record (EDR) data in private practices (3). Type of research was not associated with data sources used, but research topics/questions were. The most commonly reported advantages of reusing electronic data were being able to study large samples and saving time, while data quality and the inability to capture study-specific data were identified as major limitations.

CONCLUSIONS

Dental research reusing electronic patient data is nascent but accelerating. Future EDR design should focus on enhancing data quality, begin to integrate research data collection and implement interoperability with electronic medical records to facilitate oral-systemic investigations.

CLINICAL SIGNIFICANCE

Measuring and improving the quality of dental care requires that we begin to reuse electronic patient data collected in practice for clinical research. Practice data can potentially serve as a useful complement to data collected in traditional research studies.

摘要

目的

临床护理期间收集的电子患者数据的再利用作为增加证据基础的一种方式受到了越来越多的关注。本文旨在回顾将电子患者数据再用于牙科研究的相关研究。

数据来源

通过检索MEDLINE和Embase数据库、手工检索7种牙科和信息学期刊以及滚雪球抽样获得1527条引文。

研究选择

我们纳入了将电子患者数据单独或与医疗状况、药物和结局相结合用于牙科和颅面主题研究。排除使用行政或研究数据库的研究以及系统评价。三名评审员独立提取数据并共同进行分析。

结果

所回顾的60项研究涵盖流行病学(32项研究)、结局(16项)、卫生服务研究(10项)和其他(2项)主题;主要为回顾性研究(58项研究);样本量(9 - 153,619名患者)和随访期(1 - 12年)差异很大;除电子数据外,经常还利用其他数据来源(25项);但很少利用私人诊所的电子牙科记录(EDR)数据(3项)。研究类型与所使用的数据来源无关,但研究主题/问题与之相关。再利用电子数据最常报告的优点是能够研究大样本和节省时间,而数据质量以及无法获取特定研究数据被确定为主要局限性。

结论

再利用电子患者数据的牙科研究尚处于起步阶段,但正在加速发展。未来EDR设计应注重提高数据质量,开始整合研究数据收集并实现与电子病历的互操作性,以促进口腔 - 全身研究。

临床意义

衡量和提高牙科护理质量要求我们开始将实践中收集的电子患者数据再用于临床研究。实践数据有可能成为传统研究中收集的数据的有益补充。

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