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A Comparison of Smoking History in the Electronic Health Record With Self-Report.

电子健康档案中吸烟史与自我报告的比较。

  • 影响因子:4.33
  • DOI:10.1016/j.amepre.2019.10.020
  • 作者列表:"Patel N","Miller DP Jr","Snavely AC","Bellinger C","Foley KL","Case D","McDonald ML","Masmoudi YR","Dharod A
  • 发表时间:2020-04-01
Abstract

INTRODUCTION:Knowing patients' smoking history helps guide who may benefit from preventive services such as lung cancer screening. The accuracy of smoking history electronic health records remains unclear. METHODS:This was a secondary analysis of data collected from a portal-based lung cancer screening decision aid. Participants of an academically affiliated health system, aged 55-76 years, completed an online survey that collected a detailed smoking history including years of smoking, years since quitting, and smoking intensity. Eligibility for lung cancer screening was defined using the Centers for Medicare and Medicaid Services criteria. Data analysis was performed May-December 2018, and data collection occurred between November 2016 and February 2017. RESULTS:A total of 336 participants completed the survey and were included in the analysis. Of 175 participants with self-reported smoking intensity, 72% had packs per day and 62% had pack-years recorded in the electronic health record. When present, smoking history in the electronic health records correlated well with self-reported years of smoking (r =0.78, p≤0.0001) and years since quitting (r =0.94, p≤0.0001). Self-reported smoking intensity, including pack-years (r =0.62, p<0.0001) and packs per day (r =0.65, p≤0.0001), was less correlated. Of those participants eligible for lung cancer screening by self-report, only 35% met criteria for screening by electronic health records data alone. Others were either incorrectly classified as ineligible (23%) or had incomplete data (41%). CONCLUSIONS:The electronic health records frequently misses critical elements of a smoking history, and when present, it often underestimates smoking intensity, which may impact who receives lung cancer screening.

摘要

简介: 了解患者的吸烟史有助于指导谁可能从肺癌筛查等预防服务中受益。吸烟史电子健康记录的准确性仍不清楚。 方法: 这是对从基于门静脉的肺癌筛查决策辅助收集的数据的二次分析。一个学术附属卫生系统的参与者,年龄在 55-76 岁之间,完成了一项在线调查,收集了详细的吸烟史,包括吸烟年限,戒烟年限和吸烟强度。使用Medicare和Medicaid服务中心标准确定肺癌筛查的资格.2018 年 5-12 月进行数据分析,数据收集时间为 2016 年 11 月至 2017 年 2 月。 结果: 共有 336 名参与者完成了调查并被纳入分析。在 175 名自我报告吸烟强度的参与者中,72% 的参与者每天服用几包,62% 的参与者在电子健康记录中记录了几包年.当存在时,电子健康记录中的吸烟史与自我报告的吸烟年数 (r = 0.78,p ≤ 0.0001) 和戒烟后的年数 (r = 0.94,p ≤ 0.0001) 密切相关。自我报告的吸烟强度,包括包年 (r = 0.62,p<0.0001) 和每天包 (r = 0.65,p ≤ 0.0001),相关性较小。在那些符合通过自我报告进行肺癌筛查的参与者中,仅 35% 的参与者符合通过电子健康记录数据进行筛查的标准。其他人被错误地归类为不合格 (23%) 或数据不完整 (41%)。 结论: 电子健康记录经常遗漏吸烟史的关键要素,当存在时,它经常低估吸烟强度,这可能会影响谁接受肺癌筛查。

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