Concordance of Data About Sex From Electronic Health Records and the National Death Index: Implications for Transgender Populations.
Concordance of Data About Sex From Electronic Health Records and the National Death Index: Implications for Transgender Populations.
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DOI：
10.1097/ede.0000000000001460
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发表时间：
2022-05-01
期刊：
影响因子：
--
通讯作者：
Boyer TL
中科院分区：
文献类型：
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作者：
Blosnich JR;Boyer TL
跨性别者比顺性别者有更大的健康风险，这可能预示着更高的死亡率。然而，由于缺乏死亡时的性别认同信息，研究受到限制。新的机会，联合收割机行政数据与国家死亡指数（NDI）数据相结合，可能会促进死亡率研究的跨性别人群，但性别和性别的二元措施可能会带来问题的分析。本研究探讨了性别的差异记录在退伍军人健康管理局（VHA）的电子健康记录（EHR）和NDI数据之间的跨性别和顺性别死者。我们使用2000-2016财年的VHA EHR数据来确定跨性别和顺性别患者样本中的死亡。我们将NDI中记录的性别与VHA EHR数据中基于EHR的性别交叉制表。我们于二零一八年提取数据，并于二零二零年进行分析。1，109名跨性别患者和7，757名顺性别患者死亡。对于顺性别死亡者，基于EHR的性别和基于NDI的性别是100%一致的。对于跨性别死者，46例（4%）数据来源之间不一致。在EHR性别为女性的跨性别死者（n = 259）中，17%在NDI数据中显示为男性;在EHR性别为男性的死者（n = 850）中，0.2%在NDI数据中显示为女性。EHR和NDI之间的数据链接可以促进跨性别死亡率的研究，但研究特定于各种跨性别身份的死亡率仍然很困难。在美国死亡率监测中，需要改进性和性别的记录。
Transgender individuals have greater health risks than cisgender individuals, which may bode for greater mortality. However, research is limited by lack of gender identity information at the time of death. Novel opportunities to combine administrative data with National Death Index (NDI) data may facilitate mortality research about transgender populations, but binary measures of sex and gender may pose problems for analyses. This study explored differences in sex recorded in Veterans Health Administration (VHA) electronic health record (EHR) and NDI data between transgender and cisgender decedents. We used VHA EHR data from fiscal years 2000-2016 to identify deaths among a sample of transgender and cisgender patients. We cross-tabulated sex recorded in the NDI with EHR-based sex from VHA EHR data. We extracted data in 2018 and conducted analyses in 2020. Death occurred for 1,109 transgender patients and 7,757 cisgender patients. For cisgender decedents, EHR-based sex and NDI-based sex were 100% concordant. For transgender decedents, 46 (4%) were discordant between data sources. Of transgender decedents with female EHR-based sex (n = 259), 17% were indicated as male in NDI data; of those with male EHR-based sex (n = 850), 0.2% were indicated as female in NDI data. Data linkage between EHR and the NDI can facilitate transgender mortality research, but examining mortality specific to various transgender identities remains difficult. Improved documentation of sex and gender is needed within US mortality surveillance.