Electronic medical record: research tool for pancreatic cancer?
Electronic medical record: research tool for pancreatic cancer?
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DOI：
10.1016/j.jss.2013.10.036
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发表时间：
2014-04-01
影响因子：
2.2
通讯作者：
Tseng, Jennifer F.
中科院分区：
文献类型：
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作者：
Arous, Edward J.;McDade, Theodore P.;Tseng, Jennifer F.
背景：基于从机构医疗保健信息系统（HIS）自动检索的新型数据仓库可与传统的前瞻性维护的手术数据库进行比较。方法：查询由 HIS 自动填充的单一机构学术医疗中心新建立的机构数据仓库，以查找胰腺肿瘤的国际疾病分类第 9 版临床修改（ICD-9-CM）诊断代码。捕获具有胰腺肿瘤 ICD-9-CM 诊断代码的患者。使用手动输入填充的前瞻性数据库进行并行查询。确定了重复的患者和任一数据集特有的患者。所有患者均经过人工检查，以确定诊断的准确性。 结果：从 1999 年至 2009 年的 HIS 关联数据集中，总共识别出 1107 名胰腺肿瘤患者。其中，254 名 (22.9%) 患者也被手术数据库捕获，而 853 名 (77.1%) 患者仅存在于 HIS 链接数据集中。对仅 HIS 组的手动审查表明，45.0% 的患者没有可识别的胰腺病理学，表明捕获错误，而 36.3% 的患者符合胰腺肿瘤，18.7% 的患者符合其他胰腺病理学。在手术数据库识别的 394 名患者中，HIS 捕获了 254 名（64.5%）名患者，而未捕获 140 名（35.5%）名患者。对仅由手术数据库捕获的患者进行的人工审查显示，85.9% 的患者患有胰腺肿瘤，14.1% 的患者患有其他胰腺病理。最后，对 254 名患者重叠的回顾表明，80.3% 的患者患有胰腺肿瘤，19.7% 的患者患有其他胰腺病理。结论：这些结果表明，对管理数据的谨慎解释仅依赖于 ICD-9-CM 诊断代码和通过先前验证的机制进行的临床相关性。由爱思唯尔公司出版
Background: A novel data warehouse based on automated retrieval from an institutional health care information system (HIS) was made available to be compared with a traditional prospectively maintained surgical database.Methods: A newly established institutional data warehouse at a single-institution academic medical center autopopulated by HIS was queried for International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes for pancreatic neoplasm. Patients with ICD-9-CM diagnosis codes for pancreatic neoplasm were captured.A parallel query was performed using a prospective database populated by manual entry. Duplicated patients and those unique to either data set were identified. All patients were manually reviewed to determine the accuracy of diagnosis.Results: A total of 1107 patients were identified from the HIS-linked data set with pancreatic neoplasm from 1999-2009. Of these, 254 (22.9%) patients were also captured by the surgical database, whereas 853 (77.1%) patients were only in the HIS-linked data set. Manual review of the HIS-only group demonstrated that 45.0% of patients were without identifiable pancreatic pathology, suggesting erroneous capture, whereas 36.3% of patients were consistent with pancreatic neoplasm and 18.7% with other pancreatic pathology. Of the 394 patients identified by the surgical database, 254 (64.5%) patients were captured by HIS, whereas 140 (35.5%) patients were not. Manual review of patients only captured by the surgical database demonstrated 85.9% with pancreatic neoplasm and 14.1% with other pancreatic pathology. Finally, review of the 254 patient overlap demonstrated that 80.3% of patients had pancreatic neoplasm and 19.7% had other pancreatic pathology.Conclusions: These results suggest that cautious interpretation of administrative data rely only on ICD-9-CM diagnosis codes and clinical correlation through previously validated mechanisms. Published by Elsevier Inc.