利用电子病历在大型医疗系统中对自闭症谱系障碍诊断进行验证
Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records.
作者信息
Coleman Karen J, Lutsky Marta A, Yau Vincent, Qian Yinge, Pomichowski Magdalena E, Crawford Phillip M, Lynch Frances L, Madden Jeanne M, Owen-Smith Ashli, Pearson John A, Pearson Kathryn A, Rusinak Donna, Quinn Virginia P, Croen Lisa A
机构信息
Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA, 91104, USA,
出版信息
J Autism Dev Disord. 2015 Jul;45(7):1989-96. doi: 10.1007/s10803-015-2358-0.
Abstract
To identify factors associated with valid Autism Spectrum Disorder (ASD) diagnoses from electronic sources in large healthcare systems. We examined 1,272 charts from ASD diagnosed youth <18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. A total of 845 were classified with 81% as a confirmed, probable, or possible ASD diagnosis. The predictors of valid ASD diagnoses were >2 diagnoses in the medical record (OR 2.94; 95% CI 2.03-4.25; p < 0.001) and being male (OR 1.51; 95% CI 1.05-2.17; p = 0.03). In large integrated healthcare settings, at least two diagnoses can be used to identify ASD patients for population-based research.
摘要
为了确定大型医疗系统中与通过电子来源获得的有效自闭症谱系障碍（ASD）诊断相关的因素。我们检查了1272份来自18岁以下被诊断为ASD的青少年的病历。专家评审员将诊断分类为确诊、很可能、可能、排除或信息不足。共有845例被分类，其中81%被诊断为确诊、很可能或可能患有ASD。有效ASD诊断的预测因素是病历中有超过2次诊断（比值比2.94；95%置信区间2.03 - 4.25；p < 0.001）以及男性（比值比1.51；95%置信区间1.05 - 2.17；p = 0.03）。在大型综合医疗环境中，至少两次诊断可用于识别基于人群研究的ASD患者。
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