Defining adolescent common mental disorders using electronic primary care data: a comparison with outcomes measured using the CIS-R.
Defining adolescent common mental disorders using electronic primary care data: a comparison with outcomes measured using the CIS-R.
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DOI：
10.1136/bmjopen-2016-013167
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发表时间：
2016-12-01
期刊：
影响因子：
2.9
通讯作者：
Macleod J
中科院分区：
文献类型：
--
作者：
Cornish RP;John A;Boyd A;Tilling K;Macleod J
比较从初级保健记录中保存的数据得出的常见精神障碍（CMD）的患病率与使用修订的临床访谈时间表（CIS-R）测量的患病率，以评估仅基于常规收集的数据的结果的潜在稳健性。使用雅芳父母和儿童纵向研究（ALSPAC）和电子初级保健记录之间的联系进行比较研究。我们研究了1562名17-18岁在ALSPAC完成CIS-R的青少年，并与他们的初级保健记录建立了联系。 ALSPAC的结果指标是个人是否符合国际疾病分类-诊断（1）CMD或（2）抑郁症的10项标准。与诊断、症状和治疗相对应的读取代码列表用于使用初级保健数据单独创建12个CMD和抑郁症的定义。我们使用CIS-R定义作为参考标准，计算了这些的灵敏度和特异性。抑郁症的敏感性为5.2%~ 24.3%，CMD的敏感性为3.8%~ 19.2%。所有定义对抑郁症的特异性均在98%以上，对CMD的特异性均在96%以上。对于这两种结果，包括当前诊断、治疗或症状的定义确定了CIS-R病例的最高比例。大多数符合基于初级保健数据的CMD病例定义的个体也符合CIS-R病例定义。相反，许多使用CIS-R识别为病例的个体在其临床记录中没有CMD的证据。这表明临床数据库可能低估了人群中CMD的负担。然而，临床记录似乎产生有效的诊断，这可能是有用的研究危险因素和CMD的后果。当从调查和临床记录中获得信息时，可以获得最大的流行病学价值。
To compare the prevalence of common mental disorders (CMDs) derived from data held in primary care records with that measured using the revised Clinical Interview Schedule (CIS-R) in order to assess the potential robustness of findings based only on routinely collected data. Comparison study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic primary care records. We studied 1562 adolescents who had completed the CIS-R in ALSPAC at age 17–18 years and had linkage established to their primary care records. Outcome measures from ALSPAC were whether or not an individual met International Classification of Diseases-10 criteria for a diagnosis of (1) a CMD or, specifically, (2) depression. Lists of Read codes corresponding to diagnoses, symptoms and treatments were used to create 12 definitions of CMD and depression alone using the primary care data. We calculated sensitivities and specificities of these, using CIS-R definitions as the reference standard. Sensitivities ranged from 5.2% to 24.3% for depression and from 3.8% to 19.2% for CMD. The specificities of all definitions were above 98% for depression and above 96% for CMD. For both outcomes, the definition that included current diagnosis, treatment or symptoms identified the highest proportion of CIS-R cases. Most individuals meeting case definitions for CMD based on primary care data also met CIS-R case definitions. Conversely many individuals identified as cases using the CIS-R had no evidence of CMD in their clinical records. This suggests that clinical databases are likely to yield underestimates of the burden of CMD in the population. However, clinical records appear to yield valid diagnoses which may be useful for studying risk factors and consequences of CMD. The greatest epidemiological value may be obtained when information is available from survey and clinical records.
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影响因子：
2.5
作者：
McGregor, Joanna;Brooks, Caroline;Lloyd, Keith
通讯作者：
Lloyd, Keith
影响因子：
7.2
作者：
Boyd A;Tilling K;Cornish R;Davies A;Humphries K;Macleod J
通讯作者：
Macleod J
影响因子：
6.6
作者：
John, A.;Marchant, A. L.;Lloyd, K.
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Lloyd, K.
影响因子：
11.3
作者：
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通讯作者：
de Graaf, Ron
影响因子：
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作者：
Brugha, TS;Bebbington, PE;Vernon, J
通讯作者：
Vernon, J