Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Can J Diabetes. 2019 Aug;43(6):392-398. doi: 10.1016/j.jcjd.2019.02.005. Epub 2019 Feb 18.
To compose and validate an electronic medical records-based case definition for pediatric diabetes in primary care.
Data from the electronic medical records of 221 primary care providers participating in the Manitoba Primary Care Research Network were extracted from April 1, 1998, to March 31, 2015. We assessed agreement among the 3 case definitions of pediatric diabetes and compared the performance of each with the clinical database of the Manitoba Diabetes Education Resource for Children and Adolescents.
Our reference dataset included 41,055 pediatric patients. Electronic medical records-based case definitions, which included billing records, health conditions lists, prescription records and laboratory results, showed substantially higher sensitivity compared to the administration-based case definition that relied on billing and prescription records (96.9% and 94.9% vs 48.5%). Our study suggests a higher prevalence of pediatric diabetes in Manitoba than was previously reported through administration-based case definitions or in patients whose data were captured in the Manitoba Diabetes Education Resource for Children and Adolescents clinical database.
We describe a novel method of calculating the prevalence of pediatric diabetes in a primary care population. This case definition will improve the surveillance of pediatric diabetes and enhance service planning and the development of strategies to support prevention and management.
构建并验证一种基于电子病历的初级保健中小儿糖尿病病例定义。
从 1998 年 4 月 1 日至 2015 年 3 月 31 日，提取参与马尼托巴初级保健研究网络的 221 名初级保健提供者的电子病历数据。我们评估了 3 种小儿糖尿病病例定义之间的一致性，并比较了每种病例定义与马尼托巴儿童和青少年糖尿病教育资源临床数据库的性能。
我们的参考数据集包括 41055 名儿科患者。基于电子病历的病例定义，包括计费记录、健康状况清单、处方记录和实验室结果，与仅依赖计费和处方记录的基于管理的病例定义相比，其敏感性要高得多（96.9%和 94.9%比 48.5%）。我们的研究表明，与基于管理的病例定义或在马尼托巴糖尿病教育资源为儿童和青少年临床数据库中捕获数据的患者相比，马尼托巴小儿糖尿病的患病率更高。
我们描述了一种在初级保健人群中计算小儿糖尿病患病率的新方法。该病例定义将改善小儿糖尿病的监测，并增强服务规划和制定支持预防和管理的策略。
