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衡量原住民和托雷斯海峡岛民护理中的重要指标:评估慢性病护理的全科医疗数据集综述。

Measuring what counts in Aboriginal and Torres Strait Islander care: a review of general practice datasets available for assessing chronic disease care.

机构信息

School of Medicine and Psychology, Australian National University, Canberra, ACT 2601, Australia.

Yardhura Walani, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia.

出版信息

Aust J Prim Health. 2024 Jul;30. doi: 10.1071/PY24017.

Abstract

Background Large datasets exist in Australia that make de-identified primary healthcare data extracted from clinical information systems available for research use. This study reviews these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples, and the extent to which the principles of Indigenous Data Sovereignty are reflected in data collection and governance arrangements. Methods Datasets were included if they collect primary healthcare clinical information system data, collect data nationally, and capture Aboriginal and Torres Strait Islander peoples. We searched PubMed and the public Internet for data providers meeting the inclusion criteria. We developed a framework to assess data providers across domains, including representativeness, usability, data quality, adherence with Indigenous Data Sovereignty and their capacity to provide insights into chronic disease. Datasets were assessed against the framework based on email interviews and publicly available information. Results We identified seven datasets. Only two datasets reported on chronic disease, collected data nationally and captured a substantial number of Aboriginal and Torres Strait Islander patients. No dataset was identified that captured a significant number of both mainstream general practice clinics and Aboriginal Community Controlled Health Organisations. Conclusions It is critical that more accurate, comprehensive and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected. These improvements must be guided by the principles of Indigenous Data Sovereignty and Governance. Validated and appropriate chronic disease indicators for Aboriginal and Torres Strait Islander peoples must be developed, including indicators of social and cultural determinants of health.

摘要

背景

澳大利亚有大量的数据集,可提供从临床信息系统中提取的去标识化初级保健数据,供研究使用。本研究回顾了这些数据集,以了解其为了解原住民和托雷斯海峡岛民的慢性病护理提供的见解,并评估了数据收集和治理安排中反映原住民数据主权原则的程度。

方法

如果数据集收集初级保健临床信息系统数据、在全国范围内收集数据并捕获原住民和托雷斯海峡岛民,则将其纳入研究。我们在 PubMed 和公共互联网上搜索符合纳入标准的数据提供者。我们制定了一个框架,从代表性、可用性、数据质量、对原住民数据主权的遵守情况以及提供慢性病见解的能力等方面对数据提供者进行评估。根据电子邮件访谈和公开信息,对数据集进行了框架评估。

结果

我们确定了七个数据集。只有两个数据集报告了慢性病,在全国范围内收集数据并捕获了大量原住民和托雷斯海峡岛民患者。没有一个数据集能够同时捕获大量主流的全科诊所和原住民社区控制的医疗组织。

结论

必须更准确、全面、具有文化意义地收集原住民和托雷斯海峡岛民的医疗保健数据。这些改进必须以原住民数据主权和治理原则为指导。必须为原住民和托雷斯海峡岛民制定经过验证和适当的慢性病指标,包括健康的社会和文化决定因素指标。

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