Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.
Expert Rev Vaccines. 2023 Jan-Dec;22(1):307-314. doi: 10.1080/14760584.2023.2189474.
Monitoring the risk of intussusception after the introduction of rotavirus vaccines is recommended by the World Health Organization (WHO). Although the validity of intussusception monitoring using electronic health records (EHRs) has been confirmed previously, no similar studies have been conducted in China. We aimed to verify the diagnosis and determine an algorithm with the best performance for identification of intussusception using Chinese EHR databases.
Using the Regional Health Information Platform in Ningbo, patients aged 0-72 months from 2015 to 2021 with any related visits for intussusception were included. The algorithms were based on diagnostic codes or keywords in different clinical scenarios, and their performance was evaluated with positive predictive value (PPV) and sensitivity in line with the Brighton guidelines.
Brighton level 1 intussusception was confirmed in 2958 patients with 3246 episodes. Fine-tuned algorithms combining the appearance of the relevant ICD-10 codes or the Chinese keyword 'Chang Tao' in any diagnostic reports with the results of enema treatments or related surgeries showed the highest sensitivity, while the highest PPV was obtained by further criteria based on typical radiographic appearances.
Intussusception could be identified and validated internally using EHRs in Ningbo.
世界卫生组织（WHO）建议监测轮状病毒疫苗接种后肠套叠的风险。尽管之前已经证实了使用电子健康记录（EHR）监测肠套叠的有效性，但在中国尚未进行类似的研究。我们旨在验证使用中国电子健康记录数据库进行肠套叠诊断和确定具有最佳性能的识别算法。
利用宁波区域卫生信息平台，纳入 2015 年至 2021 年期间任何与肠套叠相关就诊的 0-72 月龄患者。这些算法基于不同临床情况下的诊断代码或关键字，其性能通过符合布赖顿指南的阳性预测值（PPV）和敏感性进行评估。
在 2958 例患者的 3246 次肠套叠中，确认了布赖顿 1 级肠套叠。结合任何诊断报告中相关 ICD-10 代码或中文关键字“肠套叠”的出现，以及灌肠治疗或相关手术结果的精细调整算法显示出最高的敏感性，而基于典型影像学表现的进一步标准则获得了最高的 PPV。
宁波可以使用电子健康记录内部识别和验证肠套叠。
