Real-world data in primary care: validation of diagnosis of atrial fibrillation in primary care electronic medical records and estimated prevalence among consulting patients'

被引:13
作者
De Burgos-Lunar, C. [1 ,2 ]
Del Cura-Gonzalez, I [2 ,3 ,4 ]
Cardenas-Valladolid, J. [5 ,6 ,7 ,8 ]
Gomez-Campelo, P. [7 ]
Abanades-Herranz, J. C. [9 ]
Lopez-de Andres, A. [10 ]
Sotos-Prieto, M. [11 ,12 ,13 ]
Iriarte-Campo, V [6 ]
Salinero-Fort, M. A. [2 ,6 ,7 ,8 ,14 ]
机构
[1] Hosp Univ Clin San Carlos, Dept Prevent Med, Madrid, Spain
[2] Res Network Chron Primary Care & Hlth Promot RICA, Madrid, Spain
[3] Res Unit, Primary Hlth Care Management, Madrid, Spain
[4] Rey Juan Carlos Univ, Dept Med Specialties & Publ Hlth, Fac Hlth Sci, Madrid, Spain
[5] Informat Syst Dept, Primary Hlth Care Management, Madrid, Spain
[6] Biosanit Res & Innovat Fdn Primary Care FIIBAP, Madrid, Spain
[7] Hosp La Paz, Inst Hlth Res IdiPAZ, Madrid, Spain
[8] Alfonso X El Sabio Univ, Madrid, Spain
[9] Monovar Hlth Ctr, Madrid, Spain
[10] Univ Complutense Madrid, Fac Med, Dept Publ Hlth & Maternal & Child Hlth, Madrid, Spain
[11] Univ Autonoma Madrid, Dept Prevent Med & Publ Hlth, Madrid, Spain
[12] CIBERESP CIBER Epidemiol & PublicHlth, Madrid, Spain
[13] Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA USA
[14] Dept Hlth, Res & Documentat, Madrid, Spain
来源
BMC PRIMARY CARE | 2023年 / 24卷 / 01期
关键词
Atrial fibrillation; Prevalence; Electronic health records; Validation; HEALTH RECORDS; LIFETIME RISK; DISEASE;
D O I
10.1186/s12875-022-01961-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Primary care electronic medical records contain clinical-administrative information on a high percentage of the population. Before this information can be used for epidemiological purposes, its quality must be verified. This study aims to validate diagnoses of atrial fibrillation (AF) recorded in primary care electronic medical records and to estimate the prevalence of AF in the population attending primary care consultations.Methods: We performed a cross-sectional validation study of all diagnoses of AF recorded in primary care electronic medical records in Madrid (Spain). We also performed simple random sampling of diagnoses of AF (ICPC-2 code K78) registered by 55 physicians and random age-and sex-matched sampling of the records that included a diagnosis of AF. Electrocardiograms, echocardiograms, and hospital discharge or cardiology clinic reports were matched. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and overall agreement were calculated using the kappa statistic (kappa). The prevalence of AF in the community of Madrid was estimated considering the sensitivity and specificity obtained in the validation. All calculations were performed overall and by sex and age groups.Results: The degree of agreement was very high (kappa= 0.952), with a sensitivity of 97.84%, specificity of 97.39%, PPV of 97.37%, and NPV of 97.85%. The prevalence of AF in the population aged over 18 years was 2.41% (95%CI 2.39-2.42% [2.25% in women and 2.58% in men]). This increased progressively with age, reaching 16.95% in those over 80 years of age (15.5% in women and 19.44% in men).Conclusions: The validation results obtained enable diagnosis of AF recorded in primary care to be used as a tool for epidemiological studies.A high prevalence of AF was found, especially in older patients.
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页数:10
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