The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control.
The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control.
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DOI：
10.1186/s12911-022-01831-8
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发表时间：
2022-04-06
影响因子：
3.5
通讯作者：
Thorpe LE
中科院分区：
文献类型：
--
作者：
Conderino S;Bendik S;Richards TB;Pulgarin C;Chan PY;Townsend J;Lim S;Roberts TR;Thorpe LE
州癌症预防和控制计划依靠公共卫生监测数据来设定目标，以改善癌症预防和控制，计划干预措施，并评估州一级实现这些目标的进展情况。该项目的目标是评估使用基于公共数据模型变量的电子健康记录(EHR)来为这些公共卫生项目生成癌症预防和控制监测指标的有效性。遵循PRISMA范围评估扩展的方法学指导，我们进行了一项文献范围评估，以评估EHR是如何用于癌症监测的。然后，我们沿着一连串护理的连续性制定了26个指标，包括癌症风险因素、预防癌症的免疫接种、癌症筛查、异常筛查结果后的初始护理质量以及癌症负担。指标是使用公共数据模型EHR数据在纽约市(NYC)Insight临床研究网络的患者样本中计算的，并使用后分层方法加权到纽约市人口。我们使用患病率将这些估计与纽约大学朗格尼健康中心原始EHR的估计值进行比较，以评估洞察力内的信息质量，并将估计值与现有监测来源的结果进行比较，以评估有效性。在确定的401篇文章中，15%的研究目的与监测有关。我们的指标比较发现，基于洞察力EHR的风险因素指标衡量标准与外部来源的估计类似。相比之下，与外部来源的估计相比，癌症筛查和疫苗接种指标被大大低估。癌症筛查和疫苗接种通常记录在电子病历的一些部分，而这些部分没有被公共数据模型捕获。对许多护理质量指标的洞察力估计高于使用原始EHR计算的结果。通用数据模型EHR数据可以为与级联护理相关的某些指标提供丰富的信息，但可能对其他指标有很大的偏见，限制了它们在癌症预防和控制计划的监测工作中的使用。网上版载有补充材料，可在10.1186/s12911-022-01831-8查阅。
State cancer prevention and control programs rely on public health surveillance data to set objectives to improve cancer prevention and control, plan interventions, and evaluate state-level progress towards achieving those objectives. The goal of this project was to evaluate the validity of using electronic health records (EHRs) based on common data model variables to generate indicators for surveillance of cancer prevention and control for these public health programs. Following the methodological guidance from the PRISMA Extension for Scoping Reviews, we conducted a literature scoping review to assess how EHRs are used to inform cancer surveillance. We then developed 26 indicators along the continuum of the cascade of care, including cancer risk factors, immunizations to prevent cancer, cancer screenings, quality of initial care after abnormal screening results, and cancer burden. Indicators were calculated within a sample of patients from the New York City (NYC) INSIGHT Clinical Research Network using common data model EHR data and were weighted to the NYC population using post-stratification. We used prevalence ratios to compare these estimates to estimates from the raw EHR of NYU Langone Health to assess quality of information within INSIGHT, and we compared estimates to results from existing surveillance sources to assess validity. Of the 401 identified articles, 15% had a study purpose related to surveillance. Our indicator comparisons found that INSIGHT EHR-based measures for risk factor indicators were similar to estimates from external sources. In contrast, cancer screening and vaccination indicators were substantially underestimated as compared to estimates from external sources. Cancer screenings and vaccinations were often recorded in sections of the EHR that were not captured by the common data model. INSIGHT estimates for many quality-of-care indicators were higher than those calculated using a raw EHR. Common data model EHR data can provide rich information for certain indicators related to the cascade of care but may have substantial biases for others that limit their use in informing surveillance efforts for cancer prevention and control programs. The online version contains supplementary material available at 10.1186/s12911-022-01831-8.
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DOI：
10.1097/phh.0000000000000589
发表时间：
2017-07-01
影响因子：
3.3
作者：
Gutilla, Margaret J.;Davidson, Arthur J.;Magzamen, Sheryl
通讯作者：
Magzamen, Sheryl
影响因子：
2.2
作者：
Filipp, S. L.;Cardel, M.;Gurka, M. J.
通讯作者：
Gurka, M. J.
影响因子：
39
作者：
Baker, David W.;Brown, Tiffany;Wolf, Michael S.
通讯作者：
Wolf, Michael S.
影响因子：
4.4
作者：
Dhalwani, Nafeesa N.;Tata, Laila J.;Szatkowski, Lisa
通讯作者：
Szatkowski, Lisa
影响因子：
12.7
作者：
Cowburn, Stuart;Carlson, Matthew;DeVoe, Jennifer
通讯作者：
DeVoe, Jennifer