Pan-Canadian asthma and COPD standards for electronic health records: A Canadian Thoracic Society Expert Working Group Report
Pan-Canadian asthma and COPD standards for electronic health records: A Canadian Thoracic Society Expert Working Group Report
复制标题
DOI：
10.1080/24745332.2018.1517623
复制
发表时间：
2018-01-01
影响因子：
0.8
通讯作者：
To, Teresa
中科院分区：
文献类型：
--
作者：
Lougheed, M. Diane;Taite, Ann;To, Teresa
理由：加拿大胸科学会针对电子健康记录 (EHR) (PRESTINE) 制定了泛加拿大呼吸标准倡议。目标：我们旨在识别和定义哮喘、慢性阻塞性肺病 EHR 的呼吸数据元素和相关肺功能元素，以确保遵守呼吸最佳实践指南。方法：潜在数据元素 (n=425) 基于 已发布哮喘/慢性阻塞性肺病信息模型。使用修改后的兰德-加州大学洛杉矶分校适当性和德尔菲法，由 12 名专家组成的工作组 (WG) 使用 5 点李克特量表，根据 4 个领域（证据强度、清晰度、相关性、可行性）对每个要素进行独立评级，再加上总体评级（包括作为核心、可选或排除）。随后的独立投票解决了前几轮中缺乏共识（定义为 60% 一致）的问题。召开了一次面对面会议，寻求工作组共识。所包含的数据元素定义和药物列表已发送给外部利益相关者审查。 主要结果：经过 4 轮投票（包括面对面会议），工作组确定了哮喘的 77 个核心元素和 23 个可选元素，以及 COPD 的 72 个核心元素和 21 个可选元素。其中，53 个核心要素和 15 个可选要素对于哮喘和 COPD 来说都是共同的。哮喘/慢性阻塞性肺病和戒烟药物清单包括 40 个产品和 48 个品牌。 结论：该共识倡议确定了哮喘、慢性阻塞性肺病和肺功能数据元素和定义，以及专家推荐纳入 EHR 的药物清单，以支持这些疾病的初级和三级护理，并实现结果监测、基准测试和绩效评估。
RATIONALE: The Canadian Thoracic Society established a pan-Canadian respiratory standards initiative for electronic health records (EHRs) (PRESTINE).OBJECTIVE: We aimed to identify and define respiratory data elements for EHRs for asthma, COPD and related pulmonary function elements that enable adherence with respiratory best practice guidelines.METHOD: Potential data elements (n=425) were based on a published asthma/COPD information model. Using modified RAND-UCLA Appropriateness and Delphi methods, a working group (WG) of 12 experts independently rated each element based on 4 domains (strength of evidence, clarity, relevance, feasibility) using a 5-point Likert Scale, plus an overall rating (include as core, optional or exclude). Subsequent independent voting rounds addressed elements lacking consensus (defined as 60% agreement) in previous rounds. A facilitated face-to-face meeting was convened during which WG consensus was sought. A list of included data element definitions and medications were sent for external stakeholder review.MAIN RESULTS: After 4 rounds of voting (including the face-to-face meeting), the WG identified 77 core and 23 optional elements for asthma, and 72 core and 21 optional elements for COPD. Of those, 53 core and 15 optional elements were common to both asthma and COPD. The list of asthma/COPD and smoking cessation medications included 40 products and 48 brands.CONCLUSIONS: This consensus initiative has identified asthma, COPD, and pulmonary function data elements and definitions as well as a list of medications recommended by experts for inclusion in EHRs to support primary and tertiary care for these diseases, and to enable outcomes monitoring, benchmarking and performance evaluation.