HIS-based Kaplan-Meier plots--a single source approach for documenting and reusing routine survival information.
HIS-based Kaplan-Meier plots--a single source approach for documenting and reusing routine survival information.
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DOI：
10.1186/1472-6947-11-11
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发表时间：
2011-02-16
影响因子：
3.5
通讯作者：
Dugas M
中科院分区：
文献类型：
--
作者：
Breil B;Semjonow A;Müller-Tidow C;Fritz F;Dugas M
生存或结局信息对临床常规和临床研究都很重要，应该完整、及时和准确地收集。这些信息与多种用途相关，包括质量控制、临床试验、观察性研究和流行病学登记。然而，当地医院信息系统（HIS）不支持该文档，因此该数据必须通过基于纸张或电子表格的方法生成，这可能导致冗余的文档数据。因此，我们研究将不同科室的随访资料整合到HIS中，并重新用于生存分析，是否可以使医生及时获得生存曲线，避免重复记录。我们分析了目前两个科室（泌尿科、血液科）肿瘤患者不同文献形式的随访过程。我们开发了一个基于通用数据模型的全面生存记录的概念，并在明斯特大学医院的HIS中实施了一个后续表格，该表格适用于这些数据的二次使用。我们设计了一个查询来从HIS中提取相关数据，并基于这些数据实现Kaplan-Meier图。为了重用这些数据，需要有足够的数据质量。我们测量了所有临床肿瘤病例表格的完整性和文件项目的完整性，因为不完整的信息会使生存分析的结果产生偏差。在形式分析的基础上，我们发现了两个部门之间的差异和一致性。我们确定了52个属性，其中13个是常见的（例如程序和诊断日期），并用于通用数据模型。电子随访表被整合到临床工作流程中。生存数据也被回顾性输入，以便对一个全面的数据集进行生存和质量分析。医生现在能够根据当前数据及时生成Kaplan-Meier图。我们分析了1992年至2010年间965例患者的1029种随访形式的生存信息。表格完整性为60.2%，项目完整性在94.3% - 98.5%之间。中位总生存时间为16.4年；中位无事件生存时间为7.7年。将生存信息整合到常规HIS文档中是可行的，这样可以直接及时地生成Kaplan-Meier图。
Survival or outcome information is important for clinical routine as well as for clinical research and should be collected completely, timely and precisely. This information is relevant for multiple usages including quality control, clinical trials, observational studies and epidemiological registries. However, the local hospital information system (HIS) does not support this documentation and therefore this data has to generated by paper based or spreadsheet methods which can result in redundantly documented data. Therefore we investigated, whether integrating the follow-up documentation of different departments in the HIS and reusing it for survival analysis can enable the physician to obtain survival curves in a timely manner and to avoid redundant documentation. We analysed the current follow-up process of oncological patients in two departments (urology, haematology) with respect to different documentation forms. We developed a concept for comprehensive survival documentation based on a generic data model and implemented a follow-up form within the HIS of the University Hospital Muenster which is suitable for a secondary use of these data. We designed a query to extract the relevant data from the HIS and implemented Kaplan-Meier plots based on these data. To re-use this data sufficient data quality is needed. We measured completeness of forms with respect to all tumour cases in the clinic and completeness of documented items per form as incomplete information can bias results of the survival analysis. Based on the form analysis we discovered differences and concordances between both departments. We identified 52 attributes from which 13 were common (e.g. procedures and diagnosis dates) and were used for the generic data model. The electronic follow-up form was integrated in the clinical workflow. Survival data was also retrospectively entered in order to perform survival and quality analyses on a comprehensive data set. Physicians are now able to generate timely Kaplan-Meier plots on current data. We analysed 1029 follow-up forms of 965 patients with survival information between 1992 and 2010. Completeness of forms was 60.2%, completeness of items ranges between 94.3% and 98.5%. Median overall survival time was 16.4 years; median event-free survival time was 7.7 years. It is feasible to integrate survival information into routine HIS documentation such that Kaplan-Meier plots can be generated directly and in a timely manner.
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影响因子：
11.1
作者：
Forster M;Bailey C;Brinkhof MW;Graber C;Boulle A;Spohr M;Balestre E;May M;Keiser O;Jahn A;Egger M;ART-LINC collaboration of International Epidemiological Databases to Evaluate AIDS
通讯作者：
ART-LINC collaboration of International Epidemiological Databases to Evaluate AIDS
影响因子：
4.1
作者：
Yang, Isaac;Sughrue, Michael E.;Parsa, Andrew T.
通讯作者：
Parsa, Andrew T.
影响因子：
1.7
作者：
Ohmann, C.;Kuchinke, W.
通讯作者：
Kuchinke, W.
DOI：
10.1197/jamia.m1118
发表时间：
2003-01-01
影响因子：
6.4
作者：
Ammenwerth, E;Mansmann, U;Eichstädter, R
通讯作者：
Eichstädter, R
DOI：
10.1197/jamia.m2157
发表时间：
2007-09-01
影响因子：
6.4
作者：
Kush, Rebecca;Alschuler, Liora;Nahm, Meredith
通讯作者：
Nahm, Meredith