Assessing Cancer History Accuracy in Primary Care Electronic Health Records Through Cancer Registry Linkage.
Assessing Cancer History Accuracy in Primary Care Electronic Health Records Through Cancer Registry Linkage.
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DOI：
10.1093/jnci/djaa210
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发表时间：
2021-07-01
期刊：
影响因子：
--
通讯作者：
Huguet N
中科院分区：
文献类型：
--
作者：
Hoopes M;Voss R;Angier H;Marino M;Schmidt T;DeVoe JE;Soule J;Huguet N
许多癌症幸存者在社区卫生中心（CHC）接受初级保健。癌症病史是提供初级保健时考虑的一个重要因素，但对CHC电子健康记录（EHR）中包含的癌症病史数据的完整性或准确性知之甚少。我们将超过150万成人CHC患者的EHR数据与加州、俄勒冈州和华盛顿的州癌症登记处的数据进行概率关联，并估计一致性指标（如Kappa、敏感性、特异性）。我们比较了每个数据源估计的癌症患者的人口统计学和临床特征，用绝对标准化平均差异评估分布差异。在两个来源之间共确定了74 707例癌症患者（仅EHR，n = 22 730;仅登记，n = 23 616;两者，n = 28 361）。在登记研究中发现的近一半癌症患者在EHR中缺少癌症记录。EHR与癌症登记（金标准）的癌症确定总体一致性为中等（kappa = 0.535）。癌症部位特异性一致性范围从显著（例如，前列腺和女性乳腺; kappa > 0.60）到一般（黑色素瘤和宫颈; kappa < 0.40）。比较从每个数据源确定的癌症患者的人口特征，组的性别，年龄和联邦贫困水平相似，但电子病历记录的情况下，显示出更大的医疗复杂性比从癌症登记处确定。EHR和癌症登记数据之间的一致性是中等的，并因癌症部位而异。这些研究结果表明，有必要制定策略，以改善CHC EHR中癌症病史信息的捕获，以确保为癌症幸存者提供充分的护理和最佳的健康结果。
Many cancer survivors receive primary care in community health centers (CHCs). Cancer history is an important factor to consider in the provision of primary care, yet little is known about the completeness or accuracy of cancer history data contained in CHC electronic health records (EHRs). We probabilistically linked EHR data from more than1.5 million adult CHC patients to state cancer registries in California, Oregon, and Washington and estimated measures of agreement (eg, kappa, sensitivity, specificity). We compared demographic and clinical characteristics of cancer patients as estimated by each data source, evaluating distributional differences with absolute standardized mean differences. A total 74 707 cancer patients were identified between the 2 sources (EHR only, n = 22 730; registry only, n = 23 616; both, n = 28 361). Nearly one-half of cancer patients identified in registries were missing cancer documentation in the EHR. Overall agreement of cancer ascertainment in the EHR vs cancer registries (gold standard) was moderate (kappa = 0.535). Cancer site–specific agreement ranged from substantial (eg, prostate and female breast; kappa > 0.60) to fair (melanoma and cervix; kappa < 0.40). Comparing population characteristics of cancer patients as ascertained from each data source, groups were similar for sex, age, and federal poverty level, but EHR-recorded cases showed greater medical complexity than those ascertained from cancer registries. Agreement between EHR and cancer registry data was moderate and varied by cancer site. These findings suggest the need for strategies to improve capture of cancer history information in CHC EHRs to ensure adequate delivery of care and optimal health outcomes for cancer survivors.
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影响因子：
1.9
作者：
Olaku OO;Taylor EA
通讯作者：
Taylor EA
影响因子：
3.7
作者：
Leach, Corinne R.;Weaver, Kathryn E.;Rowland, Julia H.
通讯作者：
Rowland, Julia H.
DOI：
10.1158/1055-9965.epi-19-0882
发表时间：
2020-04
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Thompson CA;Jin A;Luft HS;Lichtensztajn DY;Allen L;Liang SY;Schumacher BT;Gomez SL
通讯作者：
Gomez SL
影响因子：
39
作者：
Rubinstein, Ellen B.;Miller, William L.;Crabtree, Benjamin F.
通讯作者：
Crabtree, Benjamin F.
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.