Department of Family Medicine, University of Washington, Box 354982, Seattle, WA 98105, USA; Department of Obstetrics and Gynecology, University of Washington, Box 356460, Seattle, WA 98195, USA.
Department of Family Medicine, University of Washington, Box 354982, Seattle, WA 98105, USA.
Contraception. 2018 Dec;98(6):476-481. doi: 10.1016/j.contraception.2018.06.005. Epub 2018 Jun 22.
To evaluate the ability of electronic health record (EHR) data extracted into a data-sharing system to accurately identify contraceptive use.
We compared rates of contraceptive use from electronic extraction of EHR data via a data-sharing system and manual abstraction of the EHR among 142 female patients ages 15-49 years from a family medicine clinic within a primary care practice-based research network (PBRN). Cohen's kappa coefficient measured agreement between electronic extraction and manual abstraction.
Manual abstraction identified 62% of women as contraceptive users, whereas electronic extraction identified only 27%. Long acting reversible (LARC) methods had 96% agreement (Cohen's kappa 0.78; confidence interval, 0.57-0.99) between electronic extraction and manual abstraction. EHR data extracted via a data-sharing system was unable to identify barrier or over-the-counter contraceptives.
Electronic extraction found substantially lower overall rates of contraceptive method use, but produced more comparable LARC method use rates when compared to manual abstraction among women in this study's primary care clinic.
Quality metrics related to contraceptive use that rely on EHR data in this study's data-sharing system likely under-estimated true contraceptive use.
评估电子健康记录（EHR）数据提取到数据共享系统中准确识别避孕方法使用情况的能力。
我们比较了电子提取 EHR 数据并通过数据共享系统以及在初级保健实践研究网络（PBRN）内的家庭医学诊所中对 142 名 15-49 岁女性患者的 EHR 进行手动提取的避孕方法使用情况。电子提取和手动提取之间的一致性采用 Cohen's kappa 系数进行测量。
手动提取发现 62%的女性为避孕使用者，而电子提取仅发现 27%。长效可逆避孕（LARC）方法的电子提取和手动提取之间具有 96%的一致性（Cohen's kappa 0.78；置信区间，0.57-0.99）。电子提取无法识别屏障或非处方避孕方法。
与手动提取相比，电子提取发现的总体避孕方法使用率明显较低，但在这项研究的初级保健诊所中，LARC 方法的使用率更为可比。
本研究数据共享系统中基于 EHR 数据的避孕方法使用相关质量指标可能低估了真实的避孕方法使用情况。
