Development of quality measures to assess tooth decay outcomes from electronic health record data.
Development of quality measures to assess tooth decay outcomes from electronic health record data.
复制标题
制定质量措施来评估电子健康记录数据中的蛀牙结果。
DOI：
10.1111/jphd.12545
复制
发表时间：
2023
影响因子：
2.3
通讯作者：
White,JoelM
中科院分区：
文献类型：
--
作者：
Brandon,RyanG;Bangar,Suhasini;Yansane,Alfa;Neumann,Ana;Mullins,JoannaM;Kalenderian,Elsbeth;Walji,MuhammadF;White,JoelM
目的建立基于牙科电子健康记录的护理质量评价指标，以评估龋齿的发生和治疗的及时性。方法制定评估龋齿是否在6个 月内得到治疗以及在就诊的患者中是否发生新的龋齿的质量指标。算法使用EHR得出的每个牙齿表面状态的数据，比较患者在不同日期的牙齿，以确定是否治疗了龋齿或发生了新的龋齿。在三个地点进行了手工图表审查，以验证这些措施。在2016-2019年的4个历年中，对3个地点实施了这些措施并计算了分数。结果人工审查了约954张龋齿测量及时处理的图表，其测量性能的敏感度为97%，特异度为85%，阳性预测值(PPV)为91%，阴性预测值(NPV)为95%。约739张曲线图用于新的衰变测量，其灵敏度为94%，特异度为99%，PPV99%，NPV94%。在所有地点和年份，52.8%的龋齿患者在确诊后6个月内得到完全治疗(n=247959)。在年度检查中(n=640,004)，共有23.8%的患者经历了新的衰退(n=640,004)。结论根据EHR数据，开发并验证了评估衰退的及时治疗和新的衰退发生的方法，创建了有效的结果衡量标准。这些基于EHR的质量测量产生准确和可靠的结果，支持在质量评估、质量改进、患者护理和研究方面的努力和进步。
ObjectivesTo develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay.MethodsQuality 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.ResultsAbout 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).ConclusionMethods 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.