开发质量措施以评估电子健康记录数据中的龋齿结果。
Development of quality measures to assess tooth decay outcomes from electronic health record data.
机构信息
Willamette Dental Group and Skourtes Institute, Hillsboro, Oregon, USA.
School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA.
出版信息
J Public Health Dent. 2023 Mar;83(1):33-42. doi: 10.1111/jphd.12545. Epub 2022 Oct 12.
OBJECTIVES
To develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay.
METHODS
Quality measures were developed to assess whether decay was treated within 6 months and if new decay occurred in patients seen. Using EHR-derived data of the state of each tooth surface, algorithms compared the patient's teeth at different dates to determine if decay was treated or new decay had occurred. Manual chart reviews were conducted at three sites to validate the measures. The measures were implemented and scores were calculated for three sites over four calendar years, 2016 through 2019.
RESULTS
About 954 charts were manually reviewed for the timely treatment of tooth decay measure, with measure performance of sensitivity 97%, specificity 85%, positive predictive value (PPV) 91%, negative predictive value (NPV) 95%. About 739 charts were reviewed for new decay measure, with sensitivity 94%, specificity 99%, PPV 99%, and NPV 94%. Across all sites and years, 52.8% of patients with decay were fully treated within 6 months of diagnosis (n = 247,959). A total of 23.8% of patients experienced new decay, measured at an annual exam (n = 640,004).
CONCLUSION
Methods were developed and validated for assessing timely treatment of decay and occurrence of new decay derived from EHR data, creating effective outcome measures. These EHR-based quality measures produce accurate and reliable results that support efforts and advancement in quality assessment, quality improvement, patient care and research.
目的
开发源自牙科电子健康记录（EHR）的护理质量指标，以评估龋齿的发生和及时治疗情况。
方法
开发质量指标来评估龋齿是否在 6 个月内得到治疗，以及在就诊患者中是否出现新的龋齿。使用 EHR 中每个牙面状态的数据，算法将患者不同日期的牙齿进行比较，以确定是否对龋齿进行了治疗或新的龋齿是否发生。在三个地点进行了手动图表审查，以验证这些措施。这些措施在三个地点实施，并在四个日历年内（2016 年至 2019 年）计算了分数。
结果
大约有 954 份图表用于及时治疗龋齿的措施进行了手动审查，该措施的性能为敏感性 97%，特异性 85%，阳性预测值（PPV）91%，阴性预测值（NPV）95%。大约 739 份图表用于新的龋齿措施的审查，敏感性为 94%，特异性为 99%，PPV 为 99%，NPV 为 94%。在所有地点和年份中，52.8%的龋齿患者在诊断后 6 个月内得到了充分治疗（n=247959）。总共有 23.8%的患者在年度检查中出现了新的龋齿（n=640004）。
结论
已经开发并验证了从 EHR 数据评估龋齿及时治疗和新的龋齿发生的方法，创建了有效的结果指标。这些基于 EHR 的质量指标可提供准确可靠的结果，支持质量评估、质量改进、患者护理和研究方面的努力和进展。
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