How Confounder Strength Can Affect Allocation of Resources in Electronic Health Records.

Q3 Medicine
Kristine E Lynch, Brian W Whitcomb, Scott L DuVall
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引用次数: 0

Abstract

When electronic health record (EHR) data are used, multiple approaches may be available for measuring the same variable, introducing potentially confounding factors. While additional information may be gleaned and residual confounding reduced through resource-intensive assessment methods such as natural language processing (NLP), whether the added benefits offset the added cost of the additional resources is not straightforward. We evaluated the implications of misclassification of a confounder when using EHRs. Using a combination of simulations and real data surrounding hospital readmission, we considered smoking as a potential confounder. We compared ICD-9 diagnostic code assignment, which is an easily available measure but has the possibility of substantial misclassification of smoking status, with NLP, a method of determining smoking status that more expensive and time-consuming than ICD-9 code assignment but has less potential for misclassification. Classification of smoking status with NLP consistently produced less residual confounding than the use of ICD-9 codes; however, when minimal confounding was present, differences between the approaches were small. When considerable confounding is present, investing in a superior measurement tool becomes advantageous.

Abstract Image

混杂因素强度如何影响电子健康记录中的资源分配。
当使用电子健康记录(EHR)数据时,可能有多种方法可用于测量同一变量,从而引入潜在的混淆因素。虽然通过自然语言处理(NLP)等资源密集型评估方法可以收集到额外的信息并减少残留的混淆,但额外的收益是否抵消了额外资源的额外成本并不是直截了当的。我们评估了使用电子病历时混淆因素错误分类的影响。结合模拟和围绕医院再入院的真实数据,我们认为吸烟是一个潜在的混杂因素。我们比较了ICD-9诊断代码分配,这是一种容易获得的测量方法,但有可能对吸烟状况进行大量错误分类,而NLP是一种确定吸烟状况的方法,比ICD-9代码分配更昂贵和耗时,但错误分类的可能性更小。与使用ICD-9编码相比,使用NLP对吸烟状况进行分类始终产生较少的残留混淆;然而,当存在最小的混淆时,两种方法之间的差异很小。当存在相当大的混淆时,投资于一个更好的测量工具是有利的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
0
期刊介绍: Perspectives in Health Information Management is a scholarly, peer-reviewed research journal whose mission is to advance health information management practice and to encourage interdisciplinary collaboration between HIM professionals and others in disciplines supporting the advancement of the management of health information. The primary focus is to promote the linkage of practice, education, and research and to provide contributions to the understanding or improvement of health information management processes and outcomes.
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