Opioid2MME: Standardizing opioid prescriptions to morphine milligram equivalents from electronic health records.
Opioid2MME: Standardizing opioid prescriptions to morphine milligram equivalents from electronic health records.
复制标题
DOI：
10.1016/j.ijmedinf.2022.104739
复制
发表时间：
2022-03-16
影响因子：
4.9
通讯作者：
Hernandez-Boussard, Tina
中科院分区：
文献类型：
--
作者：
Lossio-Ventura, Juan Antonio;Song, Wenyu;Sainlaire, Michael;Dykes, Patricia C.;Hernandez-Boussard, Tina
关键词：
阿片类药物使用和滥用的全国性增加已成为美国的公共卫生危机，为了解决这一危机，有必要对阿片类药物处方模式进行系统的评估和监测。因此，电子健康记录（EHR）中的阿片类药物处方必须标准化为吗啡毫克当量（MME），以便于监测和监督。虽然大多数研究报告MME描述阿片类药物处方模式，但出于复制或比较目的，其数据预处理和转换过程缺乏透明度。在这项工作中，我们开发了一个基于SQL的开源框架，使用EHR处方数据将阿片类药物处方转换为MME。MME转换内部验证使用F-措施，通过手动图表审查;与两个现有的工具，如MedEx和MedXN进行比较;和框架进行了测试，在外部学术EHR系统。我们在2008-2019年的EHR中为49，060名独特患者确定了232，913张处方。我们手动注释了一个处方样本来评估框架的性能。药物信息提取的内部评价对每一条提取的信息实现了0.98至1.00的F-测量，优于MedEx和MedXN（F-评分分别为0.98和0.94）。内部EHR系统中的MME值获得了0.97的F测量值，并将3%的数据识别为离群值和7%的缺失值。在外部EHR系统中的MME转换在与开发站点获得的MME值之间获得了78.3%的一致性。结果表明，该框架是可复制的，并且能够将阿片类药物处方转换为不同医疗机构的MME。总之，这项工作为系统评估和监测整个医疗系统的阿片类药物处方模式奠定了基础。
The national increase in opioid use and misuse has become a public health crisis in the U.S. To tackle this crisis, the systematic evaluation and monitoring of opioid prescribing patterns is necessary. Thus, opioid prescriptions from electronic health records (EHRs) must be standardized to morphine milligram equivalent (MME) to facilitate monitoring and surveillance. While most studies report MMEs to describe opioid prescribing patterns, there is a lack of transparency regarding their data pre-processing and conversion processes for replication or comparison purposes. In this work, we developed a SQL-based open-source framework to convert opioid prescriptions to MMEs using EHR prescription data. The MME conversions were validated internally using F-measures through manual chart review; were compared with two existing tools, as MedEx and MedXN; and the framework was tested in an external academic EHR system. We identified 232,913 prescriptions for 49,060 unique patients in the EHRs, 2008–2019. We manually annotated a sample of prescriptions to assess the performance of the framework. The internal evaluation for medication information extraction achieved F-measures from 0.98 to 1.00 for each piece of the extracted information, outperforming MedEx and MedXN (F-Scores 0.98 and 0.94, respectively). MME values in the internal EHR system obtained a F-measure of 0.97 and identified 3% of the data as outliers and 7% missing values. The MME conversion in the external EHR system obtained 78.3% agreement between the MME values obtained with the development site. The results demonstrated that the framework is replicable and capable of converting opioid prescriptions to MMEs across different medical institutions. In summary, this work sets the groundwork for the systematic evaluation and monitoring of opioid prescribing patterns across healthcare systems.
登录
查看更多内容
DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
4.5
作者：
Mullin, Sarah;Zola, Jaroslaw;Lee, Robert;Hu, Jinwei;MacKenzie, Brianne;Brickman, Arlen;Anaya, Gabriel;Sinha, Shyamashree;Li, Angie;Elkin, Peter L.
通讯作者：
Elkin, Peter L.
影响因子：
13.8
作者：
Meisenberg, Barry R.;Grover, Jennifer;Korpon, Daniel
通讯作者：
Korpon, Daniel
CDC规定慢性疼痛的阿片类药物的指南 - 美国，2016年。
DOI：
10.1001/jama.2016.1464
发表时间：
2016-04-19
期刊：
JAMA
影响因子：
--
作者：
Dowell D;Haegerich TM;Chou R
通讯作者：
Chou R
影响因子：
14.9
作者：
Noy NF;Shah NH;Whetzel PL;Dai B;Dorf M;Griffith N;Jonquet C;Rubin DL;Storey MA;Chute CG;Musen MA
通讯作者：
Musen MA