Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study
Abstract Background To validate case definitions for eczema using primary care Electronic Medical Record (EMR) data from the Canadian Primary Care Sentential Surveillance Network (CPCSSN). Methods This study used EMR data from 1,574 primary care providers in seven Canadian provinces, representing 68...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Allergy, Asthma & Clinical Immunology |
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| Online Access: | https://doi.org/10.1186/s13223-023-00785-4 |
| _version_ | 1797811432197193728 |
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| author | Hannah Stirton Leanne Kosowan Elissa M Abrams Jennifer LP Protudjer John Queenan Alexander Singer |
| author_facet | Hannah Stirton Leanne Kosowan Elissa M Abrams Jennifer LP Protudjer John Queenan Alexander Singer |
| author_sort | Hannah Stirton |
| collection | DOAJ |
| description | Abstract Background To validate case definitions for eczema using primary care Electronic Medical Record (EMR) data from the Canadian Primary Care Sentential Surveillance Network (CPCSSN). Methods This study used EMR data from 1,574 primary care providers in seven Canadian provinces, representing 689,301 patients. Using a subset of patient records seven medical students or family medicine residents created a reference set of 1,772 patients. A total of 23 clinician-informed case definitions were validated against the reference. We assessed agreement using sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and overall accuracy. The case definitions with the best agreement statistics were deployed to estimate the prevalence of eczema in the CPCSSN. Results Case definition 1 had the highest SE (92.1%,85.0-96.5) but a lower SP (88.5%,86.7–90.1) and PPV (36.6%,33.1–40.3). Case definition 7 was the most specific case definition with a SP (99.8%, 99.4–100) and PPV (84.2%,61.2–94.7) but low SE (15.8%,9.3–24.5). Case definition 17 had a SE (75.3%, 65.7–83.3), SP (93.8%, 91.5–94.3) and PPV 43.7% (38.3–49.2). When we applied the most specific and most sensitive case definitions, we estimate the prevalence of eczema to be between 0.8 and 15.1%. Case definition 17 suggests an eczema prevalence estimate of 8.2% (8.08–8.21%). Conclusions We validated EMR-based eczema case definitions to estimate the prevalence of clinician-documented eczema. Future studies may choose to apply one or more of these definitions’ dependent on their studies objectives to inform disease surveillance as well as explore burden of illness or interventions related to eczema care in Canada. |
| first_indexed | 2024-03-13T07:23:36Z |
| format | Article |
| id | doaj.art-bb7364a5ad8c4ca69c86ac615f36f8e9 |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-03-13T07:23:36Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-bb7364a5ad8c4ca69c86ac615f36f8e92023-06-04T11:31:34ZengBMCAllergy, Asthma & Clinical Immunology1710-14922023-05-0119111110.1186/s13223-023-00785-4Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional studyHannah Stirton0Leanne Kosowan1Elissa M Abrams2Jennifer LP Protudjer3John Queenan4Alexander Singer5Division of Dermatology, Department of Medicine, University of TorontoDepartment of Family Medicine, Rady Faculty of Health Sciences, University of ManitobaDepartment of Pediatrics, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, University of ManitobaDepartment of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of ManitobaDepartment of Family Medicine, Queens UniversityDepartment of Family Medicine, Rady Faculty of Health Sciences, University of ManitobaAbstract Background To validate case definitions for eczema using primary care Electronic Medical Record (EMR) data from the Canadian Primary Care Sentential Surveillance Network (CPCSSN). Methods This study used EMR data from 1,574 primary care providers in seven Canadian provinces, representing 689,301 patients. Using a subset of patient records seven medical students or family medicine residents created a reference set of 1,772 patients. A total of 23 clinician-informed case definitions were validated against the reference. We assessed agreement using sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and overall accuracy. The case definitions with the best agreement statistics were deployed to estimate the prevalence of eczema in the CPCSSN. Results Case definition 1 had the highest SE (92.1%,85.0-96.5) but a lower SP (88.5%,86.7–90.1) and PPV (36.6%,33.1–40.3). Case definition 7 was the most specific case definition with a SP (99.8%, 99.4–100) and PPV (84.2%,61.2–94.7) but low SE (15.8%,9.3–24.5). Case definition 17 had a SE (75.3%, 65.7–83.3), SP (93.8%, 91.5–94.3) and PPV 43.7% (38.3–49.2). When we applied the most specific and most sensitive case definitions, we estimate the prevalence of eczema to be between 0.8 and 15.1%. Case definition 17 suggests an eczema prevalence estimate of 8.2% (8.08–8.21%). Conclusions We validated EMR-based eczema case definitions to estimate the prevalence of clinician-documented eczema. Future studies may choose to apply one or more of these definitions’ dependent on their studies objectives to inform disease surveillance as well as explore burden of illness or interventions related to eczema care in Canada.https://doi.org/10.1186/s13223-023-00785-4EczemaPrimary Health CareElectronic Health Records |
| spellingShingle | Hannah Stirton Leanne Kosowan Elissa M Abrams Jennifer LP Protudjer John Queenan Alexander Singer Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study Allergy, Asthma & Clinical Immunology Eczema Primary Health Care Electronic Health Records |
| title | Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study |
| title_full | Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study |
| title_fullStr | Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study |
| title_full_unstemmed | Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study |
| title_short | Validation of a primary care electronic medical records case definition for eczema: retrospective cross-sectional study |
| title_sort | validation of a primary care electronic medical records case definition for eczema retrospective cross sectional study |
| topic | Eczema Primary Health Care Electronic Health Records |
| url | https://doi.org/10.1186/s13223-023-00785-4 |
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