What gets recorded, counts: dementia recording in primary care compared with a specialist database.
What gets recorded, counts: dementia recording in primary care compared with a specialist database.
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DOI：
10.1093/ageing/afab164
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发表时间：
2021-11-10
期刊：
影响因子：
6.7
通讯作者：
Stewart RJ
中科院分区：
文献类型：
--
作者：
Davis KAS;Mueller C;Ashworth M;Broadbent M;Jewel A;Molokhia M;Perera G;Stewart RJ
电子健康记录数据库是痴呆症研究的有力工具，但数据可能受到记录不完整的影响。我们检查了在专家数据库（来自精神健康和痴呆症护理服务）中记录的痴呆症患者是否与在初级保健中记录的患者不同。对2007年至2019年期间兰贝斯DataNet（初级保健电子记录）覆盖人群的回顾性队列研究。将初级保健编码数据中的痴呆诊断文件与专家数据库（临床记录交互式搜索）中的链接记录进行比较。3，859人在初级保健代码中记录了痴呆症，4，266人在专家数据库中记录了痴呆症，其中2，886/5，239（55%）在两个来源中都有记录。总体而言，55%的人被标记为患有阿尔茨海默氏痴呆症，29%的人服用痴呆症药物，但这些比例在两种来源中的记录中显着更高。从专家数据库中确定的队列不太可能住在养老院（患病率0.73，95%置信区间0.63-0.85），有多项（0.87，0.77-0.98）或经常咨询（0.91，0.88-0.95）比那些通过初级保健代码确定的，虽然死亡率没有差异（0.98，0.91-1.06）。在初级保健和专家数据库中，痴呆症诊断记录不足。这对临床护理和研究的普遍性有影响。我们的研究结果表明，使用心理健康数据库可能代表那些有更多弱点的患者，反映了心理健康服务的差异转诊，并展示了患者的途径是如何进行数据库研究时的一个重要考虑因素。
databases of electronic health records are powerful tools for dementia research, but data can be influenced by incomplete recording. We examined whether people with dementia recorded in a specialist database (from a mental health and dementia care service) differ from those recorded in primary care. a retrospective cohort study of the population covered by Lambeth DataNet (primary care electronic records) between 2007 and 2019. Documentation of dementia diagnosis in primary care coded data and linked records in a specialist database (Clinical Records Interactive Search) were compared. 3,859 people had dementia documented in primary care codes and 4,266 in the specialist database, with 2,886/5,239 (55%) documented in both sources. Overall, 55% were labelled as having Alzheimer’s dementia and 29% were prescribed dementia medication, but these proportions were significantly higher in those documented in both sources. The cohort identified from the specialist database were less likely to live in a care home (prevalence ratio 0.73, 95% confidence interval 0.63–0.85), have multimorbidity (0.87, 0.77–0.98) or consult frequently (0.91, 0.88–0.95) than those identified through primary care codes, although mortality did not differ (0.98, 0.91–1.06). there is under-recording of dementia diagnoses in both primary care and specialist databases. This has implications for clinical care and for generalizability of research. Our results suggest that using a mental health database may under-represent those patients who have more frailty, reflecting differential referral to mental health services, and demonstrating how the patient pathways are an important consideration when undertaking database studies.
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影响因子：
6.3
作者：
Zhu, Carolyn W.;Ornstein, Katherine A.;Stern, Yaakov
通讯作者：
Stern, Yaakov
影响因子：
2.9
作者：
Burn AM;Fleming J;Brayne C;Fox C;Bunn F
通讯作者：
Bunn F
影响因子：
3.9
作者：
Mueller, Christoph;Molokhia, Mariam;Stewart, Robert
通讯作者：
Stewart, Robert
影响因子：
3.7
作者：
Pujades-Rodriguez M;Assi V;Gonzalez-Izquierdo A;Wilkinson T;Schnier C;Sudlow C;Hemingway H;Whiteley WN
通讯作者：
Whiteley WN
影响因子：
64.3
作者：
Davis, Katrina A. S.;Farooq, Saeed;Woelbert, Eva
通讯作者：
Woelbert, Eva