%0期刊文章%@ 2561-326X %I JMIR出版物%V 6% 卡塔尔世界杯8强波胆分析N 11% P e42955 %T大型综合医疗保健系统电子健康记录中的产后偏头痛编码:验证研究%A Shi,Jiaxiao %A Fassett,Michael J %A Chiu,Vicki Y %A Avila,Chantal C %A Khadka,Nehaa %A Brown,Brittany %A Patel,Pooja %A Mensah,Nana %A Xie,Fagen %A Peltier,Morgan R %A Getahun,Darios %+研究和评估部，Kaiser Permanente南加州，100 S Los Robles Avenue, Pasadena, CA, 91101，美国，1 626 564 5658，Darios.T.Getahun@kp.org %K偏头痛头痛%K验证%K诊断%K药房%K产后%K病历%K健康计划%K电子健康记录%K编码%K药房记录%K诊断代码%K EHR系统%D 2022 %7 17.11.2022 %9原始论文%J JMIR表格Res %G英文%X背景:偏头痛是一种常见的神经系统疾病，其特征为不同强度的反复头痛。偏头痛的患病率和严重程度不成比例地影响女性，特别是在产后。此外，妊娠期偏头痛与不良产妇结局有关，包括先兆子痫和产后中风。然而，由于缺乏经过验证的仪器来统一确定产后偏头痛的病例，文献中报道的患病率存在不确定性。目的:本研究旨在评估大型综合医疗保健系统电子健康档案(EHRs)中报告产后偏头痛编码的完整性和准确性，并比较ers中实施国际疾病分类，第十版，临床修改(ICD-10-CM)编码和药房记录前后的编码质量。方法:从电子病历中随机抽取2012年1月1日至2014年12月31日(《国际疾病分类，第9版，临床修改[ICD-9-CM]编码期)和2017年1月1日至2019年12月31日(ICD-10-CM编码期)2个时间段内凯撒永久南加州医院200例分娩的医疗记录进行图表回顾。两名训练有素的研究人员审查了所有200名妇女在分娩后1年内记录的产后偏头痛病例的电子病历。如果在电子病历中提到偏头痛(诊断为“是”)或偏头痛治疗处方(药房记录为“是”)，则认为女性患有产后偏头痛。 Results from the chart abstraction served as the gold standard and were compared with corresponding diagnosis and pharmacy prescription utilization records for both ICD-9-CM and ICD-10-CM coding periods through comparisons of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), as well as the summary statistics of F-score and Youden J statistic (J). The kappa statistic (κ) for interrater reliability was calculated. Results: The overall agreement between the identification of migraine headache using diagnosis codes and pharmacy records compared to the medical record review was strong. Diagnosis coding (F-score=87.8%; J=82.5%) did better than pharmacy records (F-score=72.7%; J=57.5%) when identifying cases, but combining both of these sources of data produced much greater accuracy in the identification of postpartum migraine cases (F-score=96.9%; J=99.7%) with sensitivity, specificity, PPV, and NPV of 100%, 99.7%, 93.9%, and 100%, respectively. Results were similar across the ICD-9-CM (F-score=98.7%, J=99.9%) and ICD-10-CM coding periods (F-score=94.9%; J=99.6%). The interrater reliability between the 2 research associates for postpartum migraine headache was 100%. Conclusions: Neither diagnostic codes nor pharmacy records alone are sufficient for identifying postpartum migraine cases reliably, but when used together, they are quite reliable. The completeness of the data remained similar after the implementation of the ICD-10-CM coding in the EHR system. %M 36394937 %R 10.2196/42955 %U https://formative.www.mybigtv.com/2022/11/e42955 %U https://doi.org/10.2196/42955 %U http://www.ncbi.nlm.nih.gov/pubmed/36394937