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患者报告结局应用的数据管理

Data Management for Applications of Patient Reported Outcomes.

作者信息

Bayliss E A, Tabano H A, Gill T M, Anzuoni K, Tai-Seale M, Allore H G, Ganz D A, Dublin S, Gruber-Baldini A L, Adams A L, Mazor K M

机构信息

Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, US.

Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, US.

出版信息

EGEMS (Wash DC). 2018 May 10;6(1):5. doi: 10.5334/egems.201.

Abstract

CONTEXT

Patient reported outcomes (PROs) are one means of systematically gathering meaningful subjective information for patient care, population health, and patient centered outcomes research. However, optimal data management for effective PRO applications is unclear.

CASE DESCRIPTION

Delivery systems associated with the Health Care Systems Research Network (HCSRN) have implemented PRO data collection as part of the Medicare annual Health Risk Assessment (HRA). A questionnaire assessed data content, collection, storage, and extractability in HCSRN delivery systems.

FINDINGS

Responses were received from 15 (83.3 percent) of 18 sites. The proportion of Medicare beneficiaries completing an HRA ranged from less than 10 to 42 percent. Most sites collected core HRA elements and 10 collected information on additional domains such as social support. Measures for core domains varied across sites. Data were collected at and prior to visits. Modes included paper, clinician entry, patient portals, and interactive voice response. Data were stored in the electronic health record (EHR) in scanned documents, free text, and discrete fields, and in summary databases.

MAJOR THEMES

PRO implementation requires effectively collecting, storing, extracting, and applying patient-reported data. Standardizing PRO measures and storing data in extractable formats can facilitate multi-site uses for PRO data, while access to individual PROs in the EHR may be sufficient for use at the point of care.

CONCLUSION

Collecting comparable PRO data elements, storing data in extractable fields, and collecting data from a higher proportion of eligible respondents represents an optimal approach to support multi-site applications of PRO information.

摘要

背景

患者报告结局(PROs)是系统收集有意义的主观信息以用于患者护理、人群健康及以患者为中心的结局研究的一种方式。然而,对于有效的PRO应用而言,最佳的数据管理尚不清楚。

病例描述

与医疗保健系统研究网络(HCSRN)相关的交付系统已将PRO数据收集作为医疗保险年度健康风险评估(HRA)的一部分来实施。一份调查问卷评估了HCSRN交付系统中的数据内容、收集、存储及可提取性。

研究结果

18个站点中有15个(83.3%)回复了问卷。完成HRA的医疗保险受益人的比例从不到10%到42%不等。大多数站点收集了HRA的核心要素,10个站点收集了诸如社会支持等其他领域的信息。各站点核心领域的测量方法各不相同。数据在就诊时及就诊前收集。方式包括纸质问卷、临床医生录入、患者门户及交互式语音应答。数据以扫描文档、自由文本和离散字段的形式存储在电子健康记录(EHR)中,以及存储在汇总数据库中。

主要主题

PRO的实施需要有效地收集、存储、提取和应用患者报告的数据。标准化PRO测量方法并以可提取格式存储数据有助于PRO数据的多站点使用,而在EHR中访问个体PRO可能足以满足护理点的使用需求。

结论

收集可比的PRO数据元素、将数据存储在可提取字段中以及从更高比例的符合条件的受访者中收集数据,是支持PRO信息多站点应用的最佳方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a459/5983068/200d0b95eddd/egems-6-1-201-g1.jpg

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