Self-report compared to electronic medical record across eight adult vaccines: Do results vary by demographic factors?
Self-report compared to electronic medical record across eight adult vaccines: Do results vary by demographic factors?
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DOI：
10.1016/j.vaccine.2013.06.041
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发表时间：
2013-08-20
期刊：
影响因子：
5.5
通讯作者：
Euler, G.
中科院分区：
文献类型：
--
作者：
Rolnick, S. J.;Parker, E. D.;Euler, G.
免疫接种对预防疾病至关重要，因此，准确衡量人群的疫苗接种状况是有针对性的预防工作的重要指南。为了全面评估8种最常见成人疫苗自报成人接种状况的有效性，我们对大型医疗系统中社区居住的患者群体进行了疫苗接种收据调查，并将其与电子病历(EMR)进行了比较。此外，我们还评估了效度是否因人口统计因素而异。这些疫苗包括：肺炎球菌(PPSV)、流感(Flu)、破伤风白喉(TD)、破伤风白喉百日咳(Tdap)、人乳头瘤病毒(HPV)、甲型肝炎(HEPA)、乙肝(HepB)和带状疱疹(Hiple)。对11,760人进行了电话调查，其中18人有记录地接受了疫苗接种，另一半没有接种。我们测量了疫苗接种的敏感度、特异度、阳性预测值和阴性预测值、净偏倚和漏报和漏报。然而，不同疫苗的敏感度和特异度并不因年龄或种族/民族而有很大差异。对HEPA的敏感性从63%到90%以上(破伤风、HPV、带状疱疹和流感)。与白人相比，拉美裔声称接受疫苗接种的可能性是白人的2.7倍。对于PPSV和流感，与年轻患者相比，65岁以上患者的特异性较低，而最年轻年龄组的患者对HEPA和乙肝的特异性最低。除了种族/族裔差异外，退休人员和家庭收入低于75,000美元的人多报的情况更多。疫苗接种监测的准确信息对于估计实现疫苗接种复盖目标的进展情况以及确保为公共卫生作出适当的政策决定和分配资源十分重要。我们的发现清楚地表明，EMR和自我报告并不总是一致的。找到改进EMR数据捕获和患者意识的方法将是有益的。(C)2013爱思唯尔有限公司。保留所有权利。
Immunizations are crucial to the prevention of disease, thus, having an accurate measure of vaccination status for a population is an important guide in targeting prevention efforts. In order to comprehensively assess the validity of self-reported adult vaccination status for the eight most common adult vaccines we conducted a survey of vaccination receipt and compared it to the electronic medical record (EMR), which was used as the criterion standard, in a population of community-dwelling patients in a large healthcare system. In addition, we assessed whether validity varied by demographic factors. The vaccines included: pneumococcal (PPSV), influenza (Flu), tetanus diphtheria (Td), tetanus diphtheria pertussis (Tdap), Human Papilloma Virus (HPV), hepatitis A (HepA), hepatitis B (HepB) and herpes zoster (shingles). Telephone surveys were conducted with 11,760 individuals, >= 18, half with documented receipt of vaccination and half without. We measured sensitivity, specificity, positive and negative predictive value, net bias and over- and under-reporting of vaccination. Variation was found across vaccines, however, sensitivity and specificity did not vary substantially by either age or race/ethnicity. Sensitivity ranged between 63% for HepA to over 90% (tetanus, HPV, shingles and Flu). Hispanics were 2.7 times more likely to claim receipt of vaccination compared to whites. For PPSV and Flu those 65+ had low specificity compared to patients of younger ages while those in the youngest age group had lowest specificity for HepA and HepB. In addition to racial/ethnic differences, over-reporting was more frequent in those retired and those with household income less than $75,000. Accurate information for vaccination surveillance is important to estimate progress toward vaccination coverage goals and ensure appropriate policy decisions and allocation of resources for public health. It was clear from our findings that EMR and self-report do not always agree. Finding approaches to improve both EMR data capture and patient awareness would be beneficial. (C) 2013 Elsevier Ltd. All rights reserved.