Feasibility of Using Electronic Health Records for Cascade Monitoring and Cost Estimates in Implementation Science Studies in the Adolescent Trials Network for HIV/AIDS Interventions.
Feasibility of Using Electronic Health Records for Cascade Monitoring and Cost Estimates in Implementation Science Studies in the Adolescent Trials Network for HIV/AIDS Interventions.
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DOI：
10.2196/25483
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发表时间：
2022-04-25
影响因子：
2.2
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中科院分区：
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防治艾滋病毒/艾滋病斗争中最困难的领域之一是向13至24岁的青年伸出援手。艾滋病毒/艾滋病感染者中接受抗逆转录病毒治疗和病毒检测不到的青年比例很低，这突出表明在实现联合国艾滋病毒联合规划署的目标方面存在重大挑战。本研究旨在评估获得关键临床指标和监测治疗，病毒抑制和保留组件的青少年艾滋病毒治疗级联在青少年试验网络艾滋病毒/艾滋病干预诊所使用电子健康记录（EHR）下载的可行性，并提供基线特征的研究参与者。EHR数据系统地从多个临床站点获得，并用于有意义地捕获临床特征，抗逆转录病毒药物的启动和护理保留，这是疾病控制和预防中心的4个连续护理措施的一部分。此外，本研究使用随附于当前手术术语代码的标准成本值来估计每次访视的成本。4个疾病控制和预防中心治疗级联措施中只有2个使用常规EHR数据进行评估。电子健康记录数据不足以监测艾滋病毒检测或与护理的联系，因为没有分母数据。然而，这些数据对于衡量抗逆转录病毒疗法的启动和充分的护理保留是有效的。这些网站基本上能够提供所需数据的信息。然而，在大多数情况下，这些数据不足以识别错过预约的模式，因为这种错过没有在EHR系统中捕获。能够良好访问数据管理资源的研究中心可以更有效地进行级联监测研究。需要EHR以外的数据来衡量艾滋病毒检测和与青年护理的联系。电子健康记录数据对于衡量抗逆转录病毒治疗的启动是有用的，并且对于衡量护理中的保留情况也有一定的作用。在为计划使用EHR数据的临床研究寻找研究中心合作伙伴时，研究中心数据管理资源应成为选择过程的一部分。研究规划者应确定为需要额外信息技术或数据管理资源的组织提供额外资金的可行性。
One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets. This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study participants. EHR data were systematically obtained from multiple clinical sites and used to meaningfully capture clinical characteristics, initiation of antiretrovirals, and retention in care, which are part of the Centers for Disease Control and Prevention’s 4 continuum of care measures. In addition, this study used standard cost values attached to Current Procedural Terminology codes to estimate the cost per visit. Only 2 of the 4 Centers for Disease Control and Prevention treatment cascade measures were assessed using routine EHR data. EHR data are not adequate for monitoring HIV testing or linkage to care because denominator data are not available. However, the data work well for measuring ART initiation and adequately for retention in care. The sites were broadly able to provide information for the required data. However, in most cases, these data are insufficient for identifying patterns of missed appointments because such misses are not captured in the EHR system. Sites with good access to data management resources can operate more efficiently for cascade monitoring study purposes. Data other than EHRs are needed to measure HIV testing and linkage to youth care. EHR data are useful for measuring ART initiation and work moderately well for measuring retention in care. Site data management resources should be part of the selection process when looking for site partners for clinical studies that plan to use EHR data. Study planners should determine the feasibility of additional funding for organizations in need of additional information technology or data management resources.