Administrative data used to identify patients with irritable bowel syndrome
Administrative data used to identify patients with irritable bowel syndrome
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DOI：
10.1016/j.jclinepi.2007.07.013
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发表时间：
2008-06-01
影响因子：
7.2
通讯作者：
Gurwitz, Jerry H.
中科院分区：
文献类型：
--
作者：
Goff, Sarah L.;Feld, Andrew;Gurwitz, Jerry H.
目的：为了评估健康计划管理数据的有用性，以确定患者肠易激综合征（IBS）研究设计和设置：在这个回顾性研究的442例患者的医疗记录，在9个美国健康计划，五套标准，使用行政数据被用来确定潜在的IBS患者。医师评审员对IBS诊断的可能性进行了评估。如果医师审查员根据病历审查将病例分类为明确、很可能或可能，则认为存在IBS。还进行了分析与病例分类为可能放置在一个“IBS不存在”category.Results：阳性预测值（PPV）的五套标准范围从63%到83%，最高的PPV发现与最严格的标准之一。当将可能诊断的病例纳入“不存在IBS”类别时，5种诊断标准的PPV均显著降低，范围为33%~ 63%。结论：不同诊断标准的PPV差异很大。使用具有较高PPV的标准可能会以牺牲普遍性为代价。2008年爱思唯尔公司All rights reserved.
Objective: To assess the usefulness of health plan administrative data for identifying patients with irritable bowel syndrome (IBS).Study Design and Setting: In this retrospective study of 442 medical records of patients in nine U.S. health plans, five sets of criteria that used administrative data were used to identify potential IBS patients. Physician reviewers provided an assessment of the likelihood of the diagnosis of IBS being present. IBS was considered to be present if the physician reviewer categorized the case as definite, probable, or possible based on medical record review. Analyses were also performed with cases categorized as possible placed in an "IBS not present" category.Results: The positive predictive value (PPV) for the five sets of criteria ranged from 63% to 83% with the highest PPV found with one of the most restrictive criteria. When cases characterized as possible were included in the "IBS not present" category, the PPV for each of the five sets of criteria decreased substantially, ranging from 33% to 63%.Conclusion: The PPV of different criteria used to identify patients with IBS from administrative data varies substantially based on the criteria that are used. Use of criteria with a higher PPV may come at the expense of generalizability. 2008 Elsevier Inc. All rights reserved.