加拿大 COVID-19 急诊科快速反应网络人群登记系统的开发：方法学研究。
Development of the Canadian COVID-19 Emergency Department Rapid Response Network population-based registry: a methodology study.
机构信息
Department of Emergency Medicine (Hohl, Taylor, Andolfatto, Ting, Brar, Stachura), University of British Columbia; Centre for Clinical Epidemiology & Evaluation (Hohl), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Emergency Medicine (McRae), Foothills Medical Center, Calgary, Alta.; Department of Emergency Medicine (Brooks), School of Medicine, Queen's University; Kingston Health Sciences Centre (Brooks), Kingston, Ont.; Department of Family Medicine and Emergency Medicine (Archambault), Faculty of Medicine, Université Laval; VITAM (Centre de recherche en santé durable) (Archambault, Mercier), Québec, Que.; Division of EMS (Fok, Dahn, Wiemer), Department of Emergency Medicine, Dalhousie University; Charles V. Keating Emergency and Trauma Centre (Fok, Dahn, Wiemer), QEII Health Sciences Centre, Halifax, NS; Department of Emergency Medicine (Davis), College of Medicine, University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Jelic), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Emergency Department (Turner), Jewish General Hospital; Department of Emergency Medicine (Turner), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Department of Emergency Medicine (Rowe, Hayward, Khangura), Faculty of Medicine & Dentistry, and School of Public Health (Rowe), University of Alberta, Edmonton, Alta.; Centre de recherche (Mercier), CHU de Québec, Université Laval, Québec, Que.; Sunnybrook Health Sciences Centre (Cheng, Atzema); Division of Emergency Medicine (Cheng, Landes, Vaillancourt, Morrison), Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ont.; Emergency Department (Taylor), Royal Columbian Hospital, New Westminster, BC; Départements de médecine de famille et de médecine d'urgence (Daoust), Faculté de médecine, Université de Montréal; Hôpital du Sacré-Coeur-de-Montréal (Daoust), CIUSSS Nord-de-l'ile-de-Montréal, Montréal, Que.; Department of Emergency Medicine (Ohle), Health Sciences North; Northern Ontario School of Medicine (Ohle), Sudbury, Ont.; Lions Gate Hospital (Andolfatto, Stachura), North Vancouver, BC; ICES Central (Atzema); University Health Network (Landes), Toronto, Ont.; Department of Emergency Medicine (Lang), Cumming School of Medicine, University of Calgary; Rockyview General Hospital (Lang), Calgary, Alta.; Department of Family Practice (Martin), Faculty of Medicine, University of British Columbia, Vancouver, BC; Abbotsford Regional Hospital & Cancer Agency (Martin), Abbotsford, BC; Department of Emergency Medicine (Mohindra), North York General Hospital, North York, Ont.; Department of Emergency Medicine (Vaillancourt, Morrison), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Division of Emergency Medicine (Welsford), Department of Medicine, McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Surrey Memorial Hospital (Brar), Surrey, BC; Department of Emergency Medicine (Yadav, Perry), University of Ottawa; Ottawa Hospital Research Institute (Yadav, Perry), Ottawa, Ont.; Division of Emergency Medicine (Yan), Department of Medicine, London Health Sciences Centre; Schulich School of Medicine and Dentistry (Yan), Western University, London, Ont.; BC SUPPORT Unit (McGavin), Vancouver, BC
Department of Emergency Medicine (Hohl, Taylor, Andolfatto, Ting, Brar, Stachura), University of British Columbia; Centre for Clinical Epidemiology & Evaluation (Hohl), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Emergency Medicine (McRae), Foothills Medical Center, Calgary, Alta.; Department of Emergency Medicine (Brooks), School of Medicine, Queen's University; Kingston Health Sciences Centre (Brooks), Kingston, Ont.; Department of Family Medicine and Emergency Medicine (Archambault), Faculty of Medicine, Université Laval; VITAM (Centre de recherche en santé durable) (Archambault, Mercier), Québec, Que.; Division of EMS (Fok, Dahn, Wiemer), Department of Emergency Medicine, Dalhousie University; Charles V. Keating Emergency and Trauma Centre (Fok, Dahn, Wiemer), QEII Health Sciences Centre, Halifax, NS; Department of Emergency Medicine (Davis), College of Medicine, University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Jelic), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Emergency Department (Turner), Jewish General Hospital; Department of Emergency Medicine (Turner), Faculty of Medicine and Health Sciences, McGill University, Montréal, Que.; Department of Emergency Medicine (Rowe, Hayward, Khangura), Faculty of Medicine & Dentistry, and School of Public Health (Rowe), University of Alberta, Edmonton, Alta.; Centre de recherche (Mercier), CHU de Québec, Université Laval, Québec, Que.; Sunnybrook Health Sciences Centre (Cheng, Atzema); Division of Emergency Medicine (Cheng, Landes, Vaillancourt, Morrison), Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ont.; Emergency Department (Taylor), Royal Columbian Hospital, New Westminster, BC; Départements de médecine de famille et de médecine d'urgence (Daoust), Faculté de médecine, Université de Montréal; Hôpital du Sacré-Coeur-de-Montréal (Daoust), CIUSSS Nord-de-l'ile-de-Montréal, Montréal, Que.; Department of Emergency Medicine (Ohle), Health Sciences North; Northern Ontario School of Medicine (Ohle), Sudbury, Ont.; Lions Gate Hospital (Andolfatto, Stachura), North Vancouver, BC; ICES Central (Atzema); University Health Network (Landes), Toronto, Ont.; Department of Emergency Medicine (Lang), Cumming School of Medicine, University of Calgary; Rockyview General Hospital (Lang), Calgary, Alta.; Department of Family Practice (Martin), Faculty of Medicine, University of British Columbia, Vancouver, BC; Abbotsford Regional Hospital & Cancer Agency (Martin), Abbotsford, BC; Department of Emergency Medicine (Mohindra), North York General Hospital, North York, Ont.; Department of Emergency Medicine (Vaillancourt, Morrison), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Division of Emergency Medicine (Welsford), Department of Medicine, McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Surrey Memorial Hospital (Brar), Surrey, BC; Department of Emergency Medicine (Yadav, Perry), University of Ottawa; Ottawa Hospital Research Institute (Yadav, Perry), Ottawa, Ont.; Division of Emergency Medicine (Yan), Department of Medicine, London Health Sciences Centre; Schulich School of Medicine and Dentistry (Yan), Western University, London, Ont.; BC SUPPORT Unit (McGavin), Vancouver, BC.
出版信息
CMAJ Open. 2021 Mar 17;9(1):E261-E270. doi: 10.9778/cmajo.20200290. Print 2021 Jan-Mar.
BACKGROUND
Emergency physicians lack high-quality evidence for many diagnostic and treatment decisions made for patients with suspected or confirmed coronavirus disease 2019 (COVID-19). Our objective is to describe the methods used to collect and ensure the data quality of a multicentre registry of patients presenting to the emergency department with suspected or confirmed COVID-19.
METHODS
This methodology study describes a population-based registry that has been enrolling consecutive patients presenting to the emergency department with suspected or confirmed COVID-19 since Mar. 1, 2020. Most data are collected from retrospective chart review. Phone follow-up with patients at 30 days captures the World Health Organization clinical improvement scale and contextual, social and cultural variables. Phone follow-up also captures patient-reported quality of life using the Veterans Rand 12-Item Health Survey at 30 days, 60 days, 6 months and 12 months. Fifty participating emergency departments from 8 provinces in Canada currently enrol patients into the registry.
INTERPRETATION
Data from the registry of the Canadian COVID-19 Emergency Department Rapid Response Network will be used to derive and validate clinical decision rules to inform clinical decision-making, describe the natural history of the disease, evaluate COVID-19 diagnostic tests and establish the real-world effectiveness of treatments and vaccines, including in populations that are excluded or underrepresented in clinical trials. This registry has the potential to generate scientific evidence to inform our pandemic response, and to serve as a model for the rapid implementation of population-based data collection protocols for future public health emergencies.
TRIAL REGISTRATION
Clinicaltrials.gov, no. NCT04702945.
背景
急诊医师在为疑似或确诊 2019 年冠状病毒病（COVID-19）患者做出许多诊断和治疗决策时缺乏高质量的证据。我们的目标是描述一项多中心登记研究中用于收集和确保数据质量的方法，该研究登记了因疑似或确诊 COVID-19 而到急诊科就诊的患者。
方法
本方法学研究描述了一项基于人群的登记研究，自 2020 年 3 月 1 日以来，该研究一直在连续登记因疑似或确诊 COVID-19 而到急诊科就诊的患者。大多数数据是通过回顾性病历审查收集的。在 30 天时通过电话随访患者，以获取世界卫生组织临床改善量表以及背景、社会和文化变量。在 30 天、60 天、6 个月和 12 个月时，电话随访还会通过退伍军人 12 项健康调查（Veterans Rand 12-Item Health Survey）收集患者的报告生活质量。目前，加拿大 8 个省的 50 个参与急诊部将患者纳入该登记研究。
诠释
加拿大 COVID-19 急诊科快速反应网络登记处的数据将用于推导和验证临床决策规则，以指导临床决策，描述疾病的自然病程，评估 COVID-19 诊断测试，并确定治疗方法和疫苗的真实世界效果，包括在临床试验中被排除或代表性不足的人群。该登记处有可能生成科学证据，为我们的大流行应对提供信息，并为未来公共卫生紧急情况快速实施基于人群的数据收集协议提供模型。
试验注册
Clinicaltrials.gov，编号 NCT04702945。
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