Sensitivity of Electronic Alcohol Diagnoses

电子酒精诊断的灵敏度

• 批准号: 6785481
• 负责人: CAROL CONELL
• 金额: $ 49.25万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-01 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6785481
• 关键词: age difference; alcoholism /alcohol abuse; alcoholism /alcohol abuse information system; automated medical record system; behavioral /social science research tag; clinical research; computer assisted diagnosis; computer assisted medical decision making; computer assisted patient care; diagnosis design /evaluation; diagnosis quality /standard; gender difference; geographic difference; health care service organization; health care service planning; health services research tag; human data; longitudinal human study; managed care; mental disorder diagnosis; outpatient care; patient care; patient oriented research; statistics /biometry

DESCRIPTION (provided by applicant): By using chart review to validate electronic alcohol diagnoses, the proposed research will make electronic data more useful in planning and evaluating alcohol treatment, and in conducting research using health plan administrative data. Chart review has been the accepted method for identifying alcohol disorders and other medical problems within health plans. However, as electronic practice databases, notification systems, and medical records proliferate, using these electronic data becomes attractive. Their easy access and low cost make their use inevitable for both research and evaluation, and for resource planning. However, to use them appropriately, we must know-what information will be missed when electronic indices are substituted for indices based on chart review, whether electronic indices will distort inter-group comparisons, and how to adjust prevalence estimates when comparing electronically identified and chart review based prevalence estimates. The proposed analyses use chart review to validate electronic identification of alcohol abuse and dependence in 3 health maintenance organizations (HMOs), of Kaiser Permanente. It is able to make a substantial contribution to this research area because of its large scale - it can examine important characteristics, by which practice might vary. We measure the sensitivity of electronic identification relative to chart review for each HMO, and we also assess heterogeneity in the quality of electronic alcohol diagnoses. We test for gender differences, for lower sensitivity when electronic databases are first initiated, and for differences between outpatient and inpatient diagnoses. We examine how reliably electronic data replicate the chart-review based diagnostic classification of alcohol and other substance abuse problems. Since the optimal observation period for estimating prevalence from health care data is under debate, we compare the sensitivity of one and three-year estimates. The results will enable researchers and health planners to monitor changing service needs effectively, using electronic alcohol diagnoses.

描述（由申请人提供）：通过使用图表审查来验证电子酒精诊断，拟议的研究将使电子数据在计划和评估酒精治疗以及使用健康计划管理数据进行研究方面更有用。图表审查是确定健康计划中酒精疾病和其他医学问题的公认方法。但是，随着电子实践数据库，通知系统和病历的增殖，使用这些电子数据变得有吸引力。他们的轻松访问和低成本使他们不可避免地用于研究和评估以及资源计划。但是，要适当地使用它们，我们必须知道，基于图表审查将电子指数替换为指数，电子指数是否会扭曲组间比较以及如何在比较电子识别和图表审查基于图表审查的患者估计值时，将丢失什么信息。 拟议的分析使用图表审查来验证Kaiser Permanente的3个健康维护组织（HMO）中对酒精滥用和依赖的电子识别。由于其大规模，它可以为该研究领域做出重大贡献 - 它可以检查重要的特征，而实践可能会有所不同。我们测量了电子识别相对于每个HMO的图表审查的灵敏度，并且还评估了电子酒精诊断质量的异质性。我们测试性别差异，首先启动电子数据库以及门诊和住院诊断之间的差异，以降低灵敏度。我们研究了如何可靠的电子数据复制基于图表的酒精和其他药物滥用问题的诊断分类。 由于估计卫生保健数据患病率的最佳观察期正在争论中，因此我们比较了一年和三年估计的敏感性。结果将使研究人员和健康规划人员能够使用电子酒精诊断有效地监视不断变化的服务需求。