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电子健康记录在预防青少年保健中识别儿童心理健康问题的作用。

The Usefulness of Electronic Health Records From Preventive Youth Healthcare in the Recognition of Child Mental Health Problems.

机构信息

Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands.

GGD Hollands Midden, Leiden, Netherlands.

出版信息

Front Public Health. 2021 May 31;9:658240. doi: 10.3389/fpubh.2021.658240. eCollection 2021.

DOI:10.3389/fpubh.2021.658240
PMID:34136452
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8202822/
Abstract

Early identification of child mental health problems (MHPs) is important to provide adequate, timely treatment. Dutch preventive youth healthcare monitors all aspects of a child's healthy development. We explored the usefulness of their electronic health records (EHRs) in scientific research and aimed to develop prediction models for child MHPs. Population-based cohort study with anonymously extracted electronic healthcare data from preventive youth healthcare centers in the Leiden area, the Netherlands, from the period 2005-2015. Data was analyzed with respect to its continuity, percentage of cases and completeness. Logistic regression analyses were conducted to develop prediction models for the risk of a first recorded concern for MHPs in the next scheduled visit at age 3/4, 5/6, 10/11, and 13/14 years. We included 26,492 children. The continuity of the data was low and the number of concerns for MHPs varied greatly. A large number of determinants had missing data for over 80% of the children. The discriminatory performance of the prediction models were poor. This is the first study exploring the usefulness of EHRs from Dutch preventive youth healthcare in research, especially in predicting child MHPs. We found the usefulness of the data to be limited and the performance of the developed prediction models was poor. When data quality can be improved, e.g., by facilitating accurate recording, or by data enrichment from other available sources, the analysis of EHRs might be helpful for better identification of child MHPs.

摘要

早期识别儿童心理健康问题(MHP)对于提供充分、及时的治疗至关重要。荷兰预防青少年保健监测儿童健康发展的各个方面。我们探讨了他们的电子健康记录(EHR)在科学研究中的有用性,并旨在开发儿童 MHP 的预测模型。

这是一项基于人群的队列研究,使用荷兰莱顿地区预防青少年保健中心的匿名提取的电子医疗保健数据,时间范围为 2005 年至 2015 年。对数据的连续性、案例百分比和完整性进行了分析。进行逻辑回归分析,以开发在接下来的 3/4 岁、5/6 岁、10/11 岁和 13/14 岁的预定就诊时首次记录的儿童心理健康问题风险的预测模型。

我们纳入了 26492 名儿童。数据的连续性较低,儿童心理健康问题的数量差异很大。大量决定因素的数据缺失率超过 80%的儿童。预测模型的区分性能较差。

这是第一项探讨荷兰预防青少年保健电子健康记录在研究中的有用性的研究,特别是在预测儿童心理健康问题方面。我们发现数据的有用性有限,开发的预测模型的性能较差。当数据质量可以提高时,例如通过促进准确记录,或通过其他可用来源的数据丰富化,对 EHR 的分析可能有助于更好地识别儿童心理健康问题。

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Research and Reporting Considerations for Observational Studies Using Electronic Health Record Data.利用电子健康记录数据进行观察性研究的研究和报告注意事项。
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Identification of children at risk for mental health problems in primary care-Development of a prediction model with routine health care data.在初级保健中识别有心理健康问题风险的儿童——利用常规医疗保健数据开发预测模型
EClinicalMedicine. 2019 Oct 17;15:89-97. doi: 10.1016/j.eclinm.2019.09.007. eCollection 2019 Oct.
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