Diabetes Screening Reminder for Women With Prior Gestational Diabetes: A Randomized Controlled Trial.
Diabetes Screening Reminder for Women With Prior Gestational Diabetes: A Randomized Controlled Trial.
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DOI：
10.1097/aog.0000000000000883
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发表时间：
2015-07
影响因子：
7.2
通讯作者：
Seely EW
中科院分区：
文献类型：
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作者：
Zera CA;Bates DW;Stuebe AM;Ecker JL;Seely EW
评估电子健康记录提示是否能提高妊娠期糖尿病（GDM）妇女2型糖尿病（T2DM）的筛查率。我们随机将初级保健提供者（按诊所地点）分配到电子健康记录中提示的T2DM筛查组或常规护理组。通过实验室结果和问题列表的自动搜索，确定了既往患有GDM的妇女。我们比较了研究期间（2010-2012年）干预点和对照点妇女的筛查率。在850名参与者的样本量中，我们有80%的能力检测出15%的筛查率差异。我们纳入了在研究期间在参与诊所就诊的847人，其中471人在提醒诊所，376人在对照诊所。两组接受T2DM筛查的女性比例相似（提示组N=265, 56.3% vs对照组N=206, 54.8%, p=0.67；调整后OR 1.04, 95% CI 0.79, 1.38）。与糖尿病风险相关的患者特征包括BMI （aOR / kg/m2 1.05, 95% CI 1.01, 1.08）和种族（非白种人aOR 2.14, 95% CI 1.57, 2.92）与筛查显著相关。一个简单的电子健康记录提醒并没有增加既往患有GDM的女性的糖尿病筛查率。
To evaluate whether an electronic health record reminder improves rates of screening for type 2 diabetes (T2DM) in women with prior gestational diabetes (GDM). We randomly allocated primary care providers (by clinic site) to a reminder for T2DM screening within the electronic health record or to usual care. Women with previous GDM were identified through an automated search of laboratory results and the problem list. We compared rates of screening during the study period (2010–2012) in women at intervention sites with those at control sites. With a sample size of 850 participants, we had 80% power to detect a 15% difference in screening rates. We included 847 individuals seen at a participating clinic during the study period, of whom 471 were at a reminder clinic and 376 were at a control clinic. A similar proportion of women were screened for T2DM in both groups (N=265, 56.3% of the reminder group vs. N=206, 54.8% of the control group, p=0.67; adjusted OR 1.04, 95% CI 0.79, 1.38. Patient characteristics associated with risk for diabetes including BMI (aOR per kg/m2 1.05, 95% CI 1.01, 1.08) and race (aOR for non-white race 2.14, 95% CI 1.57, 2.92) were significantly associated with screening. A simple electronic health record reminder did not increase the rate of diabetes screening in women with prior GDM.