电子病历替代术后疼痛和阿片类药物反应研究中的前瞻性研究数据收集。
Electronic medical records as a replacement for prospective research data collection in postoperative pain and opioid response studies.
机构信息
Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
出版信息
Int J Med Inform. 2018 Mar;111:45-50. doi: 10.1016/j.ijmedinf.2017.12.014. Epub 2017 Dec 17.
Abstract
BACKGROUND AND AIM
Many clinical research studies claim to collect data that are also captured in the electronic medical record (EMR). We evaluate the potential for EMR data to replace prospective research data collection.
METHODS
Using a dataset of 358 surgical patients enrolled in a prospective study, we examined the completeness and agreement of EMR and study entries for several variables, including the patient's stay in the post-operative care unit (PACU), surgical pain relief and pain medication side effects.
RESULTS
For all variables with a completeness percentage, values were greater than 96%. For the adverse event variables, we found slight to substantial agreement (Cohen's kappa), ranging from 0.19 (nausea) to 0.48 (respiratory depression) to 0.73 (emesis).
CONCLUSION
The potential to use EMR data as a replacement for prospective research data collection shows promise, but for now, should be evaluated on a variable-by-variable basis.
摘要
背景与目的
许多临床研究声称收集了电子病历（EMR）中也捕获的数据。我们评估了 EMR 数据替代前瞻性研究数据收集的潜力。
方法
使用前瞻性研究中纳入的 358 名手术患者的数据集，我们检查了 EMR 和研究记录中几个变量的完整性和一致性，包括患者在术后护理单元（PACU）中的停留时间、手术疼痛缓解和疼痛药物副作用。
结果
对于所有完整性百分比的变量，值均大于 96%。对于不良事件变量，我们发现存在轻微到实质性的一致性（Cohen's kappa），范围从 0.19（恶心）到 0.48（呼吸抑制）到 0.73（呕吐）。
结论
使用 EMR 数据替代前瞻性研究数据收集的潜力有希望，但目前，应根据变量逐个进行评估。
相似文献
1
Electronic medical records as a replacement for prospective research data collection in postoperative pain and opioid response studies.电子病历替代术后疼痛和阿片类药物反应研究中的前瞻性研究数据收集。
Int J Med Inform. 2018 Mar;111:45-50. doi: 10.1016/j.ijmedinf.2017.12.014. Epub 2017 Dec 17.
2
Predicting chronic pain after major traumatic injury.预测重大创伤性损伤后的慢性疼痛。
Scand J Pain. 2019 Jul 26;19(3):453-464. doi: 10.1515/sjpain-2019-0040.
3
Comparison of opioid requirements and analgesic response in opioid-tolerant versus opioid-naïve patients after total knee arthroplasty.全膝关节置换术后阿片类药物耐受患者与阿片类药物未使用患者的阿片类药物需求量及镇痛反应比较。
Pharmacotherapy. 2008 Dec;28(12):1453-60. doi: 10.1592/phco.28.12.1453.
4
Feasibility of integrating research data collection into routine clinical practice using the electronic health record.利用电子健康记录将研究数据收集整合到常规临床实践中的可行性。
J Urol. 2014 Oct;192(4):1215-20. doi: 10.1016/j.juro.2014.04.091. Epub 2014 Apr 30.
5
Evaluation of a standardized sedation assessment for opioid administration in the post anesthesia care unit.麻醉后护理单元中用于阿片类药物给药的标准化镇静评估的评价
Pain Manag Nurs. 2014 Sep;15(3):672-81. doi: 10.1016/j.pmn.2013.11.002. Epub 2014 Jan 22.
6
The effect of methadone on postoperative quality of recovery in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, double blinded, controlled clinical trial.盐酸美沙酮对腹腔镜胆囊切除术患者术后恢复质量的影响：一项前瞻性、随机、双盲、对照临床试验。
J Clin Anesth. 2019 Mar;53:64-69. doi: 10.1016/j.jclinane.2018.09.031. Epub 2018 Oct 13.
7
A multiregional registry experience using an electronic medical record to optimize data capture for longitudinal outcomes in endovascular abdominal aortic aneurysm repair.一项多区域注册研究经验：利用电子病历优化血管内腹主动脉瘤修复纵向结局的数据采集。
J Vasc Surg. 2015 May;61(5):1160-6. doi: 10.1016/j.jvs.2014.12.055. Epub 2015 Feb 26.
8
Efficacy of Local Anesthetic With Dexamethasone on the Quality of Recovery Following Total Extraperitoneal Bilateral Inguinal Hernia Repair: A Randomized Clinical Trial.地塞米松局麻药在全腹膜外双侧腹股沟疝修补术后恢复质量中的疗效：一项随机临床试验。
JAMA Surg. 2016 Dec 1;151(12):1108-1114. doi: 10.1001/jamasurg.2016.2905.
9
The challenges of linking health insurer claims with electronic medical records.将健康保险理赔与电子病历相连接所面临的挑战。
Health Informatics J. 2014 Mar;20(1):22-34. doi: 10.1177/1460458213476506.
10
Narcotic-only Epidural Infusion for Posterior Spinal Fusion Patients: A Single-Center, Retrospective Review.单纯使用麻醉剂进行硬膜外输注用于后路脊柱融合术患者：一项单中心回顾性研究
J Pediatr Orthop. 2016 Jul-Aug;36(5):526-9. doi: 10.1097/BPO.0000000000000490.
引用本文的文献
1
Providers' Perceptions of the Effectiveness of Electronic Health Records in Identifying Opioid Misuse.医务人员对电子健康记录识别阿片类药物滥用有效性的看法。
J Healthc Manag. 2023;68(6):390-403. doi: 10.1097/JHM-D-22-00253.
2
Digital Health Data Quality Issues: Systematic Review.数字健康数据质量问题：系统评价。
J Med Internet Res. 2023 Mar 31;25:e42615. doi: 10.2196/42615.
3
An anonymization-based privacy-preserving data collection protocol for digital health data.基于匿名化的数字健康数据隐私保护数据收集协议。
Front Public Health. 2023 Mar 3;11:1125011. doi: 10.3389/fpubh.2023.1125011. eCollection 2023.
4
Development and testing of data infrastructure in the American College of Emergency Physicians' Clinical Emergency Data Registry for opioid-related research.美国急诊医师学会临床急诊数据登记处用于阿片类药物相关研究的数据基础设施的开发与测试。
J Am Coll Emerg Physicians Open. 2022 Oct 25;3(5):e12816. doi: 10.1002/emp2.12816. eCollection 2022 Oct.
5
Using Electronic Medical Record Data for Research in a Healthcare Information and Management Systems Society (HIMSS) Analytics Electronic Medical Record Adoption Model (EMRAM) Stage 7 Hospital in Beijing: Cross-sectional Study.在北京一家处于医疗保健信息与管理系统协会（HIMSS）分析电子病历采用模型（EMRAM）7级的医院中，利用电子病历数据进行研究：横断面研究。
JMIR Med Inform. 2021 Aug 3;9(8):e24405. doi: 10.2196/24405.
6
Assessing the readiness of digital data infrastructure for opioid use disorder research.评估数字数据基础设施在阿片类药物使用障碍研究中的准备情况。
Addict Sci Clin Pract. 2020 Jul 10;15(1):24. doi: 10.1186/s13722-020-00198-3.
7
Opioid Misuse and Dependence Screening Practices Prior to Surgery.术前阿片类药物滥用和依赖的筛查实践
J Surg Res. 2020 Aug;252:200-205. doi: 10.1016/j.jss.2020.03.015. Epub 2020 Apr 10.
8
Electronic medical record-based cohort selection and direct-to-patient, targeted recruitment: early efficacy and lessons learned.基于电子病历的队列选择和直接面向患者的靶向招募：早期疗效和经验教训。
J Am Med Inform Assoc. 2019 Nov 1;26(11):1209-1217. doi: 10.1093/jamia/ocz168.
本文引用的文献
1
A Harmonized Data Quality Assessment Terminology and Framework for the Secondary Use of Electronic Health Record Data.电子健康记录数据二次使用的统一数据质量评估术语和框架。
EGEMS (Wash DC). 2016 Sep 11;4(1):1244. doi: 10.13063/2327-9214.1244. eCollection 2016.
2
Recommendations for the use of operational electronic health record data in comparative effectiveness research.关于在比较效果研究中使用电子健康记录操作数据的建议。
EGEMS (Wash DC). 2013 Oct 8;1(1):1018. doi: 10.13063/2327-9214.1018. eCollection 2013.
3
Novel associations between FAAH genetic variants and postoperative central opioid-related adverse effects.脂肪酸酰胺水解酶（FAAH）基因变异与术后中枢性阿片类药物相关不良反应之间的新关联。
Pharmacogenomics J. 2015 Oct;15(5):436-42. doi: 10.1038/tpj.2014.79. Epub 2015 Jan 6.
4
Opioid-related adverse effects in children undergoing surgery: unequal burden on younger girls with higher doses of opioids.接受手术的儿童中与阿片类药物相关的不良反应：年龄较小的女孩承受更高剂量阿片类药物的负担不均。
Pain Med. 2015 May;16(5):985-97. doi: 10.1111/pme.12660. Epub 2014 Dec 17.
5
Genetic risk signatures of opioid-induced respiratory depression following pediatric tonsillectomy.小儿扁桃体切除术后阿片类药物诱发呼吸抑制的遗传风险特征
Pharmacogenomics. 2014 Nov;15(14):1749-1762. doi: 10.2217/pgs.14.137.
6
Opioid-induced respiratory depression: ABCB1 transporter pharmacogenetics.阿片类药物引起的呼吸抑制：ABCB1转运体药物遗传学
Pharmacogenomics J. 2015 Apr;15(2):119-26. doi: 10.1038/tpj.2014.56. Epub 2014 Oct 14.
7
Genetics of pain perception, COMT and postoperative pain management in children.疼痛感知的遗传学、COMT 与儿童术后疼痛管理。
Pharmacogenomics. 2014 Feb;15(3):277-84. doi: 10.2217/pgs.13.248.
8
Electronic health records: new opportunities for clinical research.电子健康记录：临床研究的新机遇。
J Intern Med. 2013 Dec;274(6):547-60. doi: 10.1111/joim.12119. Epub 2013 Oct 18.
9
Perioperative anesthetic documentation: Adherence to current Australian guidelines.围手术期麻醉记录：遵守澳大利亚现行指南。
J Anaesthesiol Clin Pharmacol. 2013 Apr;29(2):211-5. doi: 10.4103/0970-9185.111726.
10
Defining and measuring completeness of electronic health records for secondary use.定义和衡量电子健康记录在二次使用中的完整性。
J Biomed Inform. 2013 Oct;46(5):830-6. doi: 10.1016/j.jbi.2013.06.010. Epub 2013 Jun 29.
Zotero 插件