Development of quality measures to assess tooth decay outcomes from electronic health record data

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry Pub Date : 2022-10-12 DOI:10.1111/jphd.12545

Ryan G. Brandon BS, Suhasini Bangar BDS, MS, Alfa Yansane PhD, Ana Neumann DDS, MPH, PhD, Joanna M. Mullins RDH, BSDH, MHI, Elsbeth Kalenderian DDS, MPH, PhD, Muhammad F. Walji MS, PhD, Joel M. White DDS, MS

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引用次数: 1

Abstract

Objectives

To develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay.

Methods

Quality measures were developed to assess whether decay was treated within 6 months and if new decay occurred in patients seen. Using EHR-derived data of the state of each tooth surface, algorithms compared the patient's teeth at different dates to determine if decay was treated or new decay had occurred. Manual chart reviews were conducted at three sites to validate the measures. The measures were implemented and scores were calculated for three sites over four calendar years, 2016 through 2019.

Results

About 954 charts were manually reviewed for the timely treatment of tooth decay measure, with measure performance of sensitivity 97%, specificity 85%, positive predictive value (PPV) 91%, negative predictive value (NPV) 95%. About 739 charts were reviewed for new decay measure, with sensitivity 94%, specificity 99%, PPV 99%, and NPV 94%. Across all sites and years, 52.8% of patients with decay were fully treated within 6 months of diagnosis (n = 247,959). A total of 23.8% of patients experienced new decay, measured at an annual exam (n = 640,004).

Conclusion

Methods were developed and validated for assessing timely treatment of decay and occurrence of new decay derived from EHR data, creating effective outcome measures. These EHR-based quality measures produce accurate and reliable results that support efforts and advancement in quality assessment, quality improvement, patient care and research.

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制定质量措施，根据电子健康记录数据评估蛀牙结果

目的制定基于牙科电子健康记录（EHR）的护理质量测量结果，以评估蛀牙的发生和及时治疗。方法制定质量措施，以评估衰变是否在6 几个月，如果患者出现新的蛀牙。使用EHR导出的每个牙齿表面状态的数据，算法比较了患者在不同日期的牙齿，以确定是否治疗了蛀牙或发生了新的蛀牙。在三个地点进行了手动图表审查，以验证这些措施。这些措施已经实施，并在2016年至2019年的四个日历年内计算了三个地点的分数。结果约954张图表用于蛀牙测量的及时治疗，测量性能为敏感性97%，特异性85%，阳性预测值（PPV）91%，阴性预测值（NPV）95%。对大约739张图表进行了新的衰变测量，灵敏度为94%，特异性为99%，PPV为99%，NPV为94%。在所有部位和年份，52.8%的蛀牙患者在诊断后6个月内得到了充分治疗（n=247959）。在年度检查中，共有23.8%的患者出现新的蛀牙（n=640004）。结论根据EHR数据，开发并验证了评估蛀牙及时治疗和新蛀牙发生的方法，制定了有效的结果测量方法。这些基于EHR的质量测量产生了准确可靠的结果，支持在质量评估、质量改进、患者护理和研究方面的努力和进步。

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

Journal of public health dentistry 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.80

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.