How far back do we need to look to capture diagnoses in electronic health records? A retrospective observational study of hospital electronic health record data
How far back do we need to look to capture diagnoses in electronic health records? A retrospective observational study of hospital electronic health record data
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DOI：
10.1136/bmjopen-2023-080678
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发表时间：
2024-02-01
期刊：
影响因子：
2.9
通讯作者：
Witham，Miles D.
中科院分区：
文献类型：
--
作者：
Lewis，Jadene;Evison，Felicity;Witham，Miles D.
对常规收集的电子健康数据进行分析是住院患者长期病情研究和实践的关键工具。这需要准确和完整地确定广泛的诊断，而这些诊断并不总是在一个时间点记录在入院文件上。本研究旨在确定需要查询多久以前的电子医院记录以获取长期疾病诊断。设计常规收集的医院电子健康记录数据的回顾性观察性研究。设置伯明翰伊丽莎白女王医院（英国）-由PIONEER急性护理数据中心保存的相关数据。患者首次记录的慢性阻塞性肺疾病（COPD）加重入院的患者（n=560）或急性中风（n=2142）是在2018年1月至12月之间，并且在索引日期之前至少有10年的数据。对于每一个诊断，我们得出的诊断记录至少有一次在整个10年的回顾期的患者数量，然后比较这与较短的回顾期从1年到9年前的索引administration.ResultsSeven的前10名最常见的诊断在COPD数据集达到>90%的完整性6年的回顾。房颤和糖尿病在2-3年的回顾中编码>90%，但高血压和哮喘的完整性一直持续上升到10年的回顾。对于中风，前10名中有4名在5年的回顾中达到了90%的完整性;心绞痛在7年时编码>90%，而先前的短暂性脑缺血发作的完整性继续上升到10年的lookback.ConclusionA 7年回顾捕获了大多数，但不是全部，常见的诊断。回顾期应根据所研究的条件进行调整。
ObjectivesAnalysis of routinely collected electronic health data is a key tool for long-term condition research and practice for hospitalised patients. This requires accurate and complete ascertainment of a broad range of diagnoses, something not always recorded on an admission document at a single point in time. This study aimed to ascertain how far back in time electronic hospital records need to be interrogated to capture long-term condition diagnoses.DesignRetrospective observational study of routinely collected hospital electronic health record data.SettingQueen Elizabeth Hospital Birmingham (UK)-linked data held by the PIONEER acute care data hub.ParticipantsPatients whose first recorded admission for chronic obstructive pulmonary disease (COPD) exacerbation (n=560) or acute stroke (n=2142) was between January and December 2018 and who had a minimum of 10 years of data prior to the index date.Outcome measuresWe identified the most common International Classification of Diseases version 10-coded diagnoses received by patients with COPD and acute stroke separately. For each diagnosis, we derived the number of patients with the diagnosis recorded at least once over the full 10-year lookback period, and then compared this with shorter lookback periods from 1 year to 9 years prior to the index admission.ResultsSeven of the top 10 most common diagnoses in the COPD dataset reached >90% completeness by 6 years of lookback. Atrial fibrillation and diabetes were >90% coded with 2–3 years of lookback, but hypertension and asthma completeness continued to rise all the way out to 10 years of lookback. For stroke, 4 of the top 10 reached 90% completeness by 5 years of lookback; angina pectoris was >90% coded at 7 years and previous transient ischaemic attack completeness continued to rise out to 10 years of lookback.ConclusionA 7-year lookback captures most, but not all, common diagnoses. Lookback duration should be tailored to the conditions being studied.