Developing and validating a diabetes database in a large health system
Developing and validating a diabetes database in a large health system
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DOI：
10.1016/j.diabres.2006.07.007
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发表时间：
2007-03-01
影响因子：
5.1
通讯作者：
Siminerio, Linda M.
中科院分区：
文献类型：
--
作者：
Zgibor, Janice C.;Orchard, Trevor J.;Siminerio, Linda M.
背景：临床信息系统的一个组成部分是患者登记。登记使提供者能够确定人口一级的护理差距。登记册还允许快速周期的持续质量改进，有针对性的做法改变和改善的结果。大多数登记处是根据保险公司的会员资格或其他选择标准建立的。很少，如果有任何数据存在登记代表人口统计学异质populations.Methods：行政和临床数据期间1/1/2000-12/30/03进行了检查。总共检索了46，082，941份实验室报告、233，292，544份病历和9，351，415份病历摘要，代表了约200万例独特患者。糖尿病来源群体通过以下标准中的任一个的存在来鉴定：住院、急诊室或门诊就诊的ICD-9代码250（糖尿病）;任何血红蛋白Alc结果;血糖> 200 mg/dl;或糖尿病药物。糖尿病的诊断由经过培训的病历审查员对患者样本进行验证。单一指标和组合进行了检查，以确定最佳识别这些cases.Results：在两个独立的验证研究，使用两个或两个以上的指标或门诊diaposis最大化的阳性预测值（PPV）（96和97%）和灵敏度（99和100%），并确定了55,807个人。当所有具有单一门诊诊断指标的患者（其最高单一PPV为94和95%）与具有>= 2个指标的患者一起被包括时，最终样本量为65，725。结论：两个或更多指标或门诊诊断确定了一个相当大的和非选择性的糖尿病数据库，其可用于跟踪过程和结果。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Background: One component of clinical information systems is a registry of patients. Registries allow providers to identify gaps in care at the population level. Registries also allow for rapid cycle continuous quality improvement, targeted practice change and improved outcomes. Most registries are built based on membership with an insurer or other selection criteria. Little, if any data exist on registries representing demographically heterogeneous populations.Methods: Administrative and clinical data for the period 1/1/2000-12/30/03 were examined. In total, 46,082,941 lab reports, 233,292,544 medical records, and 9,351,415 medical record abstracts, representing approximately 2 million unique patients were searched. The diabetes source population was identified by presence of any one of the following criteria: ICD-9 code 250 (diabetes) for inpatient, emergency room or outpatient visits; any hemoglobin A I c result; blood glucose > 200 mg/dl; or diabetes medication. A diagnosis of diabetes was verified by trained chart reviewers on a sample of patients. Single indicators and combinations were examined to determine optimal identification of these cases.Results: In two separate validation Studies, using two or more indicators or outpatient diaposis maximized positive predictive value (PPV) (96 and 97%) and sensitivity (99 and 100%) and identified 55,807 individuals. When all patients with a single indicator of outpatient diagnosis (which had the highest single PPV of 94 and 95%) were included together with those having >= 2 indicators, the final sample size was 65,725.Conclusion: Two or more indicators or an out-patient-diagnosis identifies a sizeable and unselective diabetes database which can be used to track processes and outcomes. (c) 2006 Elsevier Ireland Ltd. All rights reserved.