Senior Clinical Research Assistant, Oregon Rural Practice-based Research Network, Portland, OR, United States.
Senior Research Project Manager, Oregon Rural Practice-based Research Network, Portland, OR, United States.
Vaccine. 2023 Sep 7;41(39):5758-5762. doi: 10.1016/j.vaccine.2023.08.017. Epub 2023 Aug 11.
Immunization Information Systems (IIS) play an important information-sharing role at the point of care, and provide vital vaccination data for research studies and policy-makers. Previous validation studies comparing the accuracy of state registry data to health records have had mixed results.
We conducted a retrospective review of EHR vaccination data for 9-17 year-old patients from 10 Oregon primary care clinics who had at least one ambulatory care visit in the past 3 years from the date of validation data collection. Data on 100 age eligible youth were captured per clinic. We compared HPV and Tdap vaccinations captured in the EHR to the Oregon ALERT IIS. All clinics were located in rural areas with both family medicine (n = 7) and pediatric (n = 3) primary care clinics.
Overall agreement for HPV vaccination between EHR and ALERT IIS was 89.4 % (k = 0.83; p < 0.05). For Tdap vaccination overall agreement was 80.8 % (k = 0.60; p < 0.05). Pediatric clinics showed a higher overall vaccine agreement for both HPV at 93.3 % (k = 0.89; p < 0.05) and Tdap at 95.3 % (k = 0.90; p < 0.05). Among clinics that used bidirectional data exchange (only family medicine clinics), HPV agreement was higher at 91 % (k = 0.85) versus 88 % (k = 0.81; p < 0.05) and was lower for Tdap 75 % with bidirectional data exchange (k = 0.50) versus 86 % without bidirectional data exchange (k = 0.70; p < 0.05). When the EHR and ALERT IIS disagreed, ALERT ISS usually had additional vaccines.
ALERT IIS data provides more accurate data than EHRs can provide when measuring vaccine delivery among adolescents in rural Oregon.
免疫信息系统（IIS）在护理点发挥着重要的信息共享作用，并为研究和决策者提供重要的疫苗接种数据。之前比较州注册数据和健康记录准确性的验证研究结果喜忧参半。
我们对俄勒冈州 10 个初级保健诊所的 9-17 岁患者的电子健康记录（EHR）疫苗接种数据进行了回顾性分析，这些患者在过去 3 年中有至少一次在验证数据采集日期后的门诊就诊。每个诊所都记录了 100 名符合年龄条件的青少年的数据。我们比较了 EHR 中捕获的 HPV 和 Tdap 疫苗接种与俄勒冈州 ALERT IIS 的数据。所有诊所均位于农村地区，包括家庭医学（n=7）和儿科（n=3）初级保健诊所。
EHR 和 ALERT IIS 之间 HPV 疫苗接种的总体一致性为 89.4%（k=0.83；p<0.05）。对于 Tdap 疫苗接种，总体一致性为 80.8%（k=0.60；p<0.05）。儿科诊所的 HPV 和 Tdap 疫苗接种总体一致性更高，分别为 93.3%（k=0.89；p<0.05）和 95.3%（k=0.90；p<0.05）。在使用双向数据交换的诊所中（仅家庭医学诊所），HPV 的一致性更高，为 91%（k=0.85），而没有双向数据交换的诊所中为 88%（k=0.81；p<0.05）；对于 Tdap，双向数据交换的一致性为 75%（k=0.50），而没有双向数据交换的诊所中为 86%（k=0.70；p<0.05）。当 EHR 和 ALERT IIS 数据不一致时，ALERT IIS 通常会提供更多的疫苗数据。
在衡量俄勒冈州农村青少年疫苗接种情况时，ALERT IIS 数据提供的数据比 EHR 更准确。
