Garies Stephanie, McBrien Kerry, Quan Hude, Manca Donna, Drummond Neil, Williamson Tyler
Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
BMC Public Health. 2021 Feb 2;21(1):264. doi: 10.1186/s12889-021-10295-w.
Hypertension is a common chronic condition affecting nearly a quarter of Canadians. Hypertension surveillance in Canada typically relies on administrative data and/or national surveys. Routinely-captured data from primary care electronic medical records (EMRs) are a complementary source for chronic disease surveillance, with longitudinal patient-level details such as sociodemographics, blood pressure, weight, prescribed medications, and behavioural risk factors. As EMR data are generated from patient care and administrative tasks, assessing data quality is essential before using for secondary purposes. This study evaluated the quality of primary care EMR data from one province in Canada within the context of hypertension surveillance.
We conducted a cross-sectional, descriptive study using primary care EMR data collected by two practice-based research networks in Alberta, Canada. There were 48,377 adults identified with hypertension from 53 clinics as of June 2018. Summary statistics were used to examine the quality of data elements considered relevant for hypertension surveillance.
Patient year of birth and sex were complete, but other sociodemographic information (ethnicity, occupation, education) was largely incomplete and highly variable. Height, weight, body mass index and blood pressure were complete for most patients (over 90%), but a small proportion of outlying values indicate data inaccuracies were present. Most patients had a relevant laboratory test present (e.g. blood glucose/glycated hemoglobin, lipid profile), though a very small proportion of values were outside a biologically plausible range. Details of prescribed antihypertensive medication, such as start date, strength, dose, frequency, were mostly complete. Nearly 80% of patients had a smoking status recorded, though only 66% had useful information (i.e. categorized as current, past, or never), and less than half had their alcohol use described; information related to amount, frequency or duration was not available.
Blood pressure and prescribed medications in primary care EMR data demonstrated good completeness and plausibility, and contribute valuable information for hypertension epidemiology and surveillance. The use of other clinical, laboratory, and sociodemographic variables should be used carefully due to variable completeness and suspected data errors. Additional strategies to improve these data at the point of entry and after data extraction (e.g. statistical methods) are required.
高血压是一种常见的慢性病，影响着近四分之一的加拿大人。加拿大的高血压监测通常依赖行政数据和/或全国性调查。从基层医疗电子病历（EMR）中常规获取的数据是慢性病监测的补充来源，包含社会人口统计学、血压、体重、处方药以及行为风险因素等患者层面的纵向详细信息。由于EMR数据是在患者护理和行政任务中生成的，在用于次要目的之前评估数据质量至关重要。本研究在高血压监测背景下评估了加拿大一个省份基层医疗EMR数据的质量。
我们使用加拿大艾伯塔省两个基于实践的研究网络收集的基层医疗EMR数据进行了一项横断面描述性研究。截至2018年6月，从53家诊所中识别出48377名患有高血压的成年人。汇总统计数据用于检查与高血压监测相关的数据元素的质量。
患者的出生年份和性别信息完整，但其他社会人口统计学信息（种族、职业、教育程度）大多不完整且差异很大。大多数患者（超过90%）的身高、体重、体重指数和血压信息完整，但一小部分异常值表明存在数据不准确的情况。大多数患者有相关的实验室检查结果（如血糖/糖化血红蛋白、血脂谱），尽管极小部分数值超出生物学合理范围。处方降压药的详细信息，如开始日期、强度、剂量、频率，大多完整。近80%的患者记录了吸烟状况，但只有66%的患者有有用信息（即分为当前、过去或从不吸烟），不到一半的患者描述了饮酒情况；关于饮酒量、频率或持续时间的信息不可用。
基层医疗EMR数据中的血压和处方药信息显示出良好的完整性和合理性，为高血压流行病学和监测提供了有价值的信息。由于完整性各异且存在可疑数据错误，其他临床、实验室和社会人口统计学变量的使用应谨慎。需要额外的策略在数据录入时和数据提取后（如统计方法）改善这些数据。
