eResearch in acute kidney injury: a primer for electronic health record research

被引:14
作者
Joyce, Emily L. [1 ,2 ,3 ,4 ]
DeAlmeida, Dilhari R. [6 ]
Fuhrman, Dana Y. [1 ,2 ,3 ,4 ,5 ]
Priyanka, Priyanka [2 ,3 ,4 ]
Kellum, John A. [2 ,3 ,4 ,5 ]
机构
[1] UPMC, Childrens Hosp Pittsburgh, Dept Pediat, Div Nephrol, Pittsburgh, PA USA
[2] UPMC, Ctr Crit Care Nephrol, Pittsburgh, PA 15219 USA
[3] Univ Pittsburgh, Pittsburgh, PA 15260 USA
[4] Investigat & Syst Modeling Acute Illness CRISMA L, Clin Res, Pittsburgh, PA 15261 USA
[5] Univ Pittsburgh, Dept Crit Care Med, Pittsburgh, PA 15260 USA
[6] Univ Pittsburgh, Dept Hlth Informat Management, Pittsburgh, PA USA
基金
美国国家卫生研究院;
关键词
acute kidney injury; AKI; EHR; electronic health record; eResearch; BASE-LINE CREATININE; PEDIATRIC INDEX; RISK-FACTORS; VALIDATION; AKI; IDENTIFICATION; PERFORMANCE; DEFINITION; CRITERIA; OUTCOMES;
D O I
10.1093/ndt/gfy052
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Acute kidney injury (AKI) has a significant impact on patient morbidity and mortality as well as overall health care costs. eResearch, which integrates information technology and information management to optimize research strategies, provides a perfect platform for necessary ongoing AKI research. With the recent adoption of a widely accepted definition of AKI and near-universal use of electronic health records, eResearch is becoming an important tool in AKI research. Conducting eResearch in AKI should ideally be based on a relatively uniform methodology. This article is the first of its kind to describe a methodology for pursuing eResearch specific to AKI and includes an illustrative database example for critically ill patients. We discuss strategies for using serum creatinine and urine output in large databases to identify and stage AKI and ways to interpolate missing values and validate data. Issues specific to the pediatric population include variation in serum creatinine with growth, varied severity of illness scoring systems and medication dosage based on weight. Many of these same strategies used to optimize AKI eResearch can be applicable to real-time AKI alerts with potential integration of additional clinical variables.
引用
收藏
页码:401 / 407
页数:7
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