The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register
The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register
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DOI：
10.1136/bmj.315.7107.524
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发表时间：
1997-08-30
影响因子：
105.7
通讯作者：
MacDonald, TM
中科院分区：
文献类型：
--
作者：
Morris, AD;Boyle, DIR;MacDonald, TM
目的：使用多个数据源的电子记录链接识别社区中的所有糖尿病患者，并将这种病例确定方法与来自初级保健的糖尿病患者登记簿进行比较。设计：电子捕获-重新捕获链接的记录包括所有到医院糖尿病诊所就诊的患者、所有带现金的糖尿病相关药物和监测设备的处方、所有出院患者、接受移动眼科筛查的患者以及区域生物化学数据库中糖化血红蛋白和血糖浓度的结果，初级保健糖尿病登记簿来自8个泰赛德综合实践的随机样本。对35 144名登记了这八种一般做法的患者的相关记录进行了详细的手工研究，从而确认了病例的确证。地点：苏格兰泰赛德地区，人口391274,1996年1月1日。主要观察指标：糖尿病患病率；不同数据来源确定的患者人口；结果：发现7596例糖尿病患者，已知糖尿病患病率为1.94%(0.21%为胰岛素依赖型糖尿病，1.73%为非胰岛素依赖型糖尿病)：63%的患者曾到医院糖尿病门诊就诊，68%的患者有糖尿病相关处方，72%的患者有流动眼科筛查，48%的患者有糖尿病生化诊断结果。另有701例患者有孤立的高血糖(血糖和GT；11.1mmoL/L)，但全科医生认为他们不是糖尿病患者。对照8种常规方法(636名糖尿病患者)的验证显示，电子链接对确定已知糖尿病的敏感性为0.96，阳性预测值为0.95。全科目录的敏感度为0.91，阳性预测值为0.98。结论：电子病历链接在识别糖尿病受试者方面比全科登记簿更敏感，并发现0.18%的有高血糖史的人群可能需要筛查未诊断的糖尿病。
Objectives: To identify all patients with diabetes in a community using electronic record linkage of multiple data sources and to compare this method of case ascertainment with registers of diabetic patients derived from primary care.Design: Electronic capture-recapture linkage of records included data on all patients attending hospital diabetes clinics, all encashed prescriptions for diabetes related drugs and monitoring equipment, all patients discharged from hospital, patients attending a mobile unit for eye screening, and results for glycated haemoglobin and plasma glucose concentrations from the regional biochemistry database, Diabetes registers from primary care were from a random sample of eight Tayside general practices. A detailed manual study of relevant records for the 35 144 patients registered with these eight general practices allowed for validation of the case ascertainment.Setting: Tayside region of Scotland, population 391 274 on 1 January 1996.Main outcome measures: Prevalence of diabetes; population of patients identified by different data sources; sensitivity and positive predictive value of ascertainment methods.Results: Electronic record linkage identified 7596 diabetic patients, giving a prevalence of known diabetes of 1.94% (0.21% insulin dependent diabetes, 1.73% non-insulin dependent): 63% of patients had attended hospital diabetes clinics, 68% had encashed diabetes related prescriptions, 72% had attended the mobile eye screening unit, and 48% had biochemical results diagnostic of diabetes. A further 701 patients had isolated hyperglycaemia (plasma glucose > 11.1 mmol/l) but were not considered diabetic by general practitioners. Validation against the eight general practices (636 diabetic patients) showed electronic linkage to have a sensitivity of 0.96 and a positive predictive value of 0.95 for ascertainment of known diabetes. General practice lists had a sensitivity of 0.91 and a positive predictive value of 0.98.Conclusions: Electronic record linkage was more sensitive than general practice registers in identifying diabetic subjects and identified an additional 0.18% of the population with a history of hyperglycaemia who might warrant screening for undiagnosed diabetes.