A novel method for estimating transgender status using electronic medical records.
A novel method for estimating transgender status using electronic medical records.
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DOI：
10.1016/j.annepidem.2016.01.004
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发表时间：
2016-03
影响因子：
5.6
通讯作者：
Goodman M
中科院分区：
文献类型：
--
作者：
Roblin D;Barzilay J;Tolsma D;Robinson B;Schild L;Cromwell L;Braun H;Nash R;Gerth J;Hunkeler E;Quinn VP;Tangpricha V;Goodman M
我们描述了一种新的算法，用于在综合医疗系统的电子病历(EMR)中识别变性人并确定他们的男性到女性(MTF)或女性到男性(FTM)身份。SAS程序扫描了2006年1月至2014年12月期间Kaiser Permanente佐治亚州EMR的相关诊断代码，以及临床记录中是否存在特定关键字(例如，“变性人”或“变性人”)。通过审查包含目标关键字的未查明的文本串，并在必要时，通过对记录进行另一次深入审查，来核实资格。一旦确认了变性人身份，就使用第二个SAS程序和另一轮文本字符串审查来评估FTM或MTF身份。在813,737名成员中，271名被确认为可能的变性人：137名仅通过关键字，25名仅通过诊断代码，109名通过代码和关键字。在这些人中，185人(68%，95%可信区间：62-74%)被确认为明确的变性人。在通过关键词、诊断代码和两者同时识别的人中，确定的变性人比例(95%顺位)分别为45%(37-54%)、56%(35-75%)和100%(96-100%)。在185名明确的变性人中，99人(54%，95%CI：46-61%)是MTF，84人(45%，95%CI：38-53%)是FTM。对于两个人来说，性别认同仍然未知。变性人的流行率(每100,000名成员)在2006年为4.4(95%可信区间：2.6-7.4)，2014年为38.7(95%可信区间：32.4-46.2)。拟议的确定变性人健康研究候选人的方法成本低，效率相对较高。它可以应用于其他类似的医疗保健系统。
We describe a novel algorithm for identifying transgender people and determining their male-to-female (MTF) or female-to-male (FTM) identity in electronic medical records (EMR) of an integrated health system. A SAS program scanned Kaiser Permanente Georgia EMR from January 2006 through December 2014 for relevant diagnostic codes, and presence of specific keywords (e.g., “transgender” or “transsexual”) in clinical notes. Eligibility was verified by review of de-identified text strings containing targeted keywords, and if needed, by an additional in-depth review of records. Once transgender status was confirmed, FTM or MTF identity was assessed using a second SAS program and another round of text string reviews. Of 813,737 members, 271 were identified as possibly transgender: 137 through keywords only, 25 through diagnostic codes only, and 109 through both codes and keywords. Of these individuals, 185 (68%, 95% confidence interval [CI]: 62-74%) were confirmed as definitely transgender. The proportions (95% CIs) of definite transgender status among persons identified via keywords, diagnostic codes, and both were 45% (37-54%), 56% (35-75%), and 100% (96-100%), respectively. Of the 185 definitely transgender people, 99 (54%, 95% CI: 46-61%) were MTF, 84 (45%, 95% CI: 38-53%) were FTM. For two persons, gender identity remained unknown. Prevalence of transgender people (per 100,000 members) was 4.4 (95% CI: 2.6-7.4) in 2006 and 38.7 (95% CI: 32.4-46.2) in 2014. The proposed method of identifying candidates for transgender health studies is low cost and relatively efficient. It can be applied in other similar health care systems.