香港精神分裂症患者电子健康记录中用药和死亡记录的可靠性

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry Pub Date : 2024-11-19 DOI:10.1016/j.ajp.2024.104315

Huiquan Zhou , Jennifer Yee Man Tang , Sherry Kit Wa Chan , Hao Luo

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引用次数: 0

摘要

本研究旨在检测香港两个广泛使用的电子病历数据库：临床管理系统（CMS）和临床数据分析与报告系统（CDARS）之间被诊断为精神分裂症患者的死亡和用药记录的可靠性。从 CMS 和 CDARS 中提取了这些患者的唯一 ID、生命状态和氯氮平处方信息。结果在CMS系统中确认的1234名患者中，有1119名（90.7%）在CDARS系统中有精神分裂症记录。CDARS 中记录的所有死亡病例均与 CMS 中的病例相符，但准确死亡日期的 PPV 为 66.4%，如果允许 30 天的误差范围，则 PPV 提高到 86.0%。在允许30天误差的情况下，氯氮平处方的PPV为96.1%，开始用药日期的PPV为91.8%。结论本研究为香港两个广泛使用的电子病历数据库中精神分裂症患者的死亡率和用药数据的可靠性提供了证据。虽然事件是否发生的记录具有很好的一致性，但事件发生的确切时间却显示出较低的可靠性，这突出表明在利用这些数据库进行研究时需要考虑数据分辨率。

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The reliability of medication and death recording in electronic health records among people with schizophrenia in Hong Kong

Objective

This study aimed to examine the reliability of death and medication records among individuals diagnosed with schizophrenia between two widely-used electronic health record (EHR) databases in Hong Kong: the Clinical Management System (CMS) and the Clinical Data Analysis and Reporting System (CDARS).

Methods

A cohort of patients with schizophrenia-spectrum disorders enrolled in public psychiatric services in Hong Kong between 1998 and 2003 was identified from the CMS. The unique IDs, vital status, and clozapine prescription information of these patients were extracted from both the CMS and CDARS. The positive predictive value (PPV) was computed to evaluate the concordance of records between the two databases.

Results

Of the 1234 patients identified in the CMS, 1119 (90.7 %) had a record of schizophrenia in the CDARS. All deaths recorded in the CDARS matched those in the CMS, but the PPV for the exact date of death was 66.4 %, improving to 86.0 % when allowing a 30-day margin of error. The PPV for clozapine prescribing was 96.1 %, and 91.8 % for the initiation date when allowing a 30-day margin of error.

Conclusion

This study provides evidence on the reliability of mortality and medication data for patients with schizophrenia in two widely-used EHR databases in Hong Kong. While the record on whether an event has occurred had excellent concordance, the exact timing of events showed lower reliability, highlighting the need to consider data resolution when utilizing these databases for research.

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来源期刊

Asian journal of psychiatry Medicine-Psychiatry and Mental Health

CiteScore

12.70

自引率

5.30%

发文量

297

审稿时长

35 days

期刊介绍： The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.