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常规医院病历数据足以识别慢性肾病患者吗?一项与实验室数据的对比研究。

Is routine hospital episode data sufficient for identifying individuals with chronic kidney disease? A comparison study with laboratory data.

作者信息

Robertson Lynn M, Denadai Lucas, Black Corri, Fluck Nicholas, Prescott Gordon, Simpson William, Wilde Katie, Marks Angharad

机构信息

University of Aberdeen, Scotland

University of Aberdeen, Scotland.

出版信息

Health Informatics J. 2016 Jun;22(2):383-96. doi: 10.1177/1460458214562286. Epub 2014 Dec 31.

Abstract

Internationally, investment in the availability of routine health care data for improving health, health surveillance and health care is increasing. We assessed the validity of hospital episode data for identifying individuals with chronic kidney disease compared to biochemistry data in a large population-based cohort, the Grampian Laboratory Outcomes, Morbidity and Mortality Study-II (n = 70,435). Grampian Laboratory Outcomes, Morbidity and Mortality Study-II links hospital episode data to biochemistry data for all adults in a health region with impaired kidney function and random samples of individuals with normal and unmeasured kidney function in 2003. We compared identification of individuals with chronic kidney disease by hospital episode data (based on International Classification of Diseases-10 codes) to the reference standard of biochemistry data (at least two estimated glomerular filtration rates <60 mL/min/1.73 m(2) at least 90 days apart). Hospital episode data, compared to biochemistry data, identified a lower prevalence of chronic kidney disease and had low sensitivity (<10%) but high specificity (>97%). Using routine health care data from multiple sources offers the best opportunity to identify individuals with chronic kidney disease.

摘要

在国际上,为改善健康、进行健康监测和医疗保健而对常规医疗保健数据可用性的投资正在增加。我们在一个大型的基于人群的队列——格兰扁实验室结果、发病率和死亡率研究-II(n = 70435)中,将医院病历数据与生化数据进行比较,评估了医院病历数据用于识别慢性肾脏病患者的有效性。格兰扁实验室结果、发病率和死亡率研究-II将2003年一个健康区域内所有肾功能受损的成年人以及肾功能正常和未测量的个体随机样本的医院病历数据与生化数据相联系。我们将根据医院病历数据(基于国际疾病分类第10版编码)对慢性肾脏病患者的识别与生化数据的参考标准(至少两次估算肾小球滤过率<60 mL/min/1.73 m²,间隔至少90天)进行比较。与生化数据相比,医院病历数据识别出的慢性肾脏病患病率较低,敏感性较低(<10%)但特异性较高(>97%)。使用来自多个来源的常规医疗保健数据为识别慢性肾脏病患者提供了最佳机会。

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