Purpose: The use of validated criteria to identify birth defects in electronic healthcare databases can avoid the cost and time-intensive efforts required to conduct chart reviews to confirm outcomes. This study evaluated the validity of various case-finding methodologies to identify neural tube defects (NTDs) in infants using an electronic healthcare database.
Methods: This analysis used data generated from a study whose primary aim was to evaluate the association between first-trimester maternal prescription opioid use and NTDs. The study was conducted within the Medication Exposure in Pregnancy Risk Evaluation Program. A broad approach was used to identify potential NTDs including diagnosis and procedure codes from inpatient and outpatient settings, death certificates and birth defect flags in birth certificates. Potential NTD cases were chart abstracted and confirmed by clinical experts. Positive predictive values (PPVs) and 95% confidence intervals (95% CI) are reported.
Results: The cohort included 113 168 singleton live-born infants: 55 960 infants with opioid exposure in pregnancy and 57 208 infants unexposed in pregnancy. Seventy-three potential NTD cases were available for the validation analysis. The overall PPV was 41% using all diagnosis and procedure codes plus birth certificates. Restricting approaches to codes recorded in the infants' medical record or to birth certificate flags increased the PPVs (72% and 80%, respectively) but missed a substantial proportion of confirmed NTDs.
Conclusions: Codes in electronic healthcare data did not accurately identify confirmed NTDs. These results indicate that chart review with adjudication of outcomes is important when conducting observational studies of NTDs using electronic healthcare data.
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http://dx.doi.org/10.1002/pds.5128 | DOI Listing |
Sci Rep
December 2024
Fidson Health Care PLC, Ibadan, Oyo State, Nigeria.
This study assessed the factors militating against the effective implementation of electronic health records (EHR) in Nigeria, the computerization of patients' health records with a lot of benefits including improved patients' satisfaction, improved care processes, reduction of patients' waiting time, and medication errors. Despite these benefits, healthcare organizations are slow to adopt the EHR system. Therefore, the study assessed the factors militating against the effective implementation of the EHR system, the level of awareness of EHR, and the utilization of electronic health records; it also investigated the factors militating against the effective implementation of EHR.
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December 2024
Center for Surgical Innovation and Engineering, Cedars Sinai Health System, Los Angeles, 90048, USA.
Mechanical failure of medical implants, especially in orthopedic poses a significant burden to the patients and healthcare system. The majority of the implant failures are diagnosed at very late stages and are of mechanical causes. This makes the diagnosis and screening of implant failure very challenging.
View Article and Find Full Text PDFNPJ Prim Care Respir Med
December 2024
ResMed Science Center, San Diego, CA, USA.
Digital health platforms for asthma self-management have demonstrated promise in improving clinical and quality of life outcomes. However, few studies have examined such an approach in a real-world, fully remote setting. As such, we evaluated the benefit of an evidence-based digital self-management platform for asthma-both on its own and when integrated into an established virtual clinical service.
View Article and Find Full Text PDFTrials
December 2024
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Background: Vancomycin, an antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA), is frequently included in empiric treatment for community-acquired pneumonia (CAP) despite the fact that MRSA is rarely implicated in CAP. Conducting polymerase chain reaction (PCR) testing on nasal swabs to identify the presence of MRSA colonization has been proposed as an antimicrobial stewardship intervention to reduce the use of vancomycin. Observational studies have shown reductions in vancomycin use after implementation of MRSA colonization testing, and this approach has been adopted by CAP guidelines.
View Article and Find Full Text PDFBMC Health Serv Res
December 2024
Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia.
Background: Electronic pharmacy (e-pharmacy) services are growing rapidly, offering increased accessibility, privacy, and value. Understanding e-pharmacy customer satisfaction, attitudes, and perceptions in Saudi Arabia is crucial for improving the services and enhancing health outcomes. This study aims to examine customers' perceptions, preferences, satisfaction, and experiences with electronic pharmacy services, including community pharmacy e-commerce.
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