A comparison of electronic health records at two major Peking University Hospitals in China to United States meaningful use objectives

Lei, Jianbo; Sockolow, Paulina S.; Guan, Pengcheng; Meng, Qun; Zhang, Jiajie

doi:10.1186/1472-6947-13-96

Cited by 35 publications

(34 citation statements)

References 5 publications

(5 reference statements)

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“…An Asia‐Pacific study corroborates our results for China, as the authors also reported EMRs as the major generic data source available for analysis . The increased number of EMR sources in China owes to the implementation of the national health reform plan wherein the government aims to have a more regularized health care distribution and hospital management system . Globally and in each region, observational studies accounted for a minor part of the identified data source leads.…”

Section: Discussionsupporting

confidence: 84%

Identification and mapping of worldwide sources of generic real‐world data

Wang¹,

Lahoz

Jawla

et al. 2019

Pharmacoepidemiology and Drug

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Purpose The demand for real‐world data as supportive evidence to traditional clinical studies has increased in the past few years. The present study aimed to identify worldwide generic sources of real‐world data and to assess completeness and suitability of selected real‐world evidence (RWE) data sources to conduct prespecified research. Methods A systematic literature review was conducted to identify generic (non‐disease specific) sources of real‐world data in Medline and Embase from January 1, 2010 to September 8, 2015. Data sources used in observational studies were identified and summarized based on their geographical distribution and the type of data. In the next step, the selected data sources were critically evaluated for their completeness. Results A total of 10,069 identified publications were screened, leading to 2635 unique data sources across 102 countries. Europe had the maximum number of data sources (n = 1163) followed by United States (n = 578), and Asia, Middle East, and African Countries (n = 374). The most common type of identified data sources across all countries was structured data sources, ie, administrative databases and registries. Of the identified data sources, 300 were selected for further investigation. From the selected databases, ~50% had confirmed information on over 60% of the investigated variables, ~61% were suitable for epidemiological research, and 60% had possibility of linkage. Conclusions The present study applied a systematic literature review approach and identified available generic sources of real‐world data worldwide, in addition to the United States and Europe, which are suitable for conducting pre‐defined researches and support future RWE studies.

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Section: Discussionsupporting

confidence: 84%

Identification and mapping of worldwide sources of generic real‐world data

Wang¹,

Lahoz

Jawla

et al. 2019

Pharmacoepidemiology and Drug

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show abstract

“…As a result of rapid development and wide use of electronic medical record (EMR) in China in recent years, an enormous amount of EMR data is being collected [25, 26]. Additionally, liver diseases, including viral hepatitis, cirrhosis, and primary liver cancer (PLC), are highly prevalent in China [27].…”

Section: Introductionmentioning

confidence: 99%

Comparison of risk adjustment methods in patients with liver disease using electronic medical record data

et al. 2017

BMC Gastroenterol

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BackgroundRisk adjustment is essential for valid comparison of patients’ health outcomes or performances of health care providers. Several risk adjustment methods for liver diseases are commonly used but the optimal approach is unknown. This study aimed to compare the common risk adjustment methods for predicting in-hospital mortality in cirrhosis patients using electronic medical record (EMR) data.MethodsThe sample was derived from Beijing YouAn hospital between 2010 and 2014. Previously validated EMR extraction methods were applied to define liver disease conditions, Charlson comorbidity index (CCI), Elixhauser comorbidity index (ECI), Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), MELD sodium (MELDNa), and five-variable MELD (5vMELD). The performance of the common risk adjustment models as well as models combining disease severity and comorbidity indexes for predicting in-hospital mortality was compared using c-statistic.ResultsOf 11,121 cirrhotic patients, 69.9% were males and 15.8% age 65 or older. The c-statistics across compared models ranged from 0.785 to 0.887. All models significantly outperformed the baseline model with age, sex, and admission status (c-statistic: 0.628). The c-statistics for the CCI, ECI, MELDNa, and CTP were 0.808, 0.825, 0.849, and 0.851, respectively. The c-statistic was 0.887 for combination of CTP and ECI, and 0.882 for combination of MELDNa score and ECI.ConclusionsThe liver disease severity indexes (i.e., CTP and MELDNa score) outperformed the CCI and ECI for predicting in-hospital mortality among cirrhosis patients using Chinese EMRs. Combining liver disease severity and comorbidities indexes could improve the discrimination power of predicting in-hospital mortality.

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“…Health care administrative policy and financial support greatly accelerated the adoption of electronic health records (EHRs) in China. According to a 2012 national survey in China, ~50% of 1,004 responding hospitals had adopted at least the basic forms of EHR and practice management systems often referred to as HIS (18). Retrospective studies based on HIS data guarantee objectivity and veracity, identify potential patterns from within large quantities of data, and provide a reference point and ideas for prospective studies and clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B patients exhibiting mild alanine aminotransferase elevation: A comparative analysis of treatment with and without Bicyclol tablets

et al. 2016

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Abstract. The aim of the present study was to analyze the medicinal effect of Bicyclol tablets on patients with chronic hepatitis B (CHB) and concomitant mild alanine aminotransferase (ALT) elevation (40-80 IU/l). A retrospective cohort study, which included patients from the hospital information system (HIS; established by the Chinese Academy of Medical Sciences) viral hepatitis database comprised of 18 third-grade class A hospitals in China, was performed. Patients were divided into an exposed group (administered with Bicyclol tablets) and a non-exposed group (no administration of Bicyclol tablets). The CHB patients that exhibited mild ALT elevation provided the curative effect analysis data set, and the patients with viral hepatitis who underwent more than two creatinine/hemoglobin/leucocyte examinations served as the safety analysis data set. The factors influencing ALT normalization rate were analyzed and the safety of Bicyclol tablets was assessed. In total, 82 pairs of patients were included in the curative effect analysis, and single factor analysis revealed that the ALT normalization rate of the exposed group was statistically significantly higher than that of the non-exposed group (P=0.040) for patients with mild ALT elevation. After adjusting for patient age, gender, baseline ALT levels, state of illness upon admission, pattern of hospitalization, hospitalization days and drug combination, the odds ratio (95% confidence interval) of the ALT normalization rate of the exposed group was 2.156 (1.103-4.215) when compared with the non-exposed group. During treatment, the occurrence rates of creatinine/hemoglobin/leucocyte level abnormalities of the exposed group, which were included in the safety analysis were statistically significantly lower than those of the non-exposed group (P<0.05). These findings indicate that Bicyclol tablets improve the ALT normalization rate of CHB patients exhibiting mild ALT elevation. IntroductionChronic hepatitis B (CHB), which is defined as persistence of hepatitis B surface antigen for six months or more, is a major public health problem. According to the World Health Organisation, there are an estimated 240 million chronically infected individuals worldwide, particularly in low-and middle-income countries (1). The major complications of CHB are cirrhosis and hepatocellular carcinoma (HCC). Between 20 and 30% of those who become chronically infected will develop these complications, and an estimated 650,000 individuals will succumb due to CHB annually (1). The majority of individuals are unaware of their hepatitis B virus (HBV) infection, and, therefore, often present at an advanced stage of the disease (1). China has been identified as a region with a high prevalence of HBV; based on the National Disease Supervision Information Management System of China, the mean reported incidence of HBV was 84.3 per 100,000 in China between 2005 and 2010 (2). Despite the reduction in the incidence of the HBV infection, there are ~93 million individuals chronically infected with HBV and ...

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A comparison of electronic health records at two major Peking University Hospitals in China to United States meaningful use objectives

Cited by 35 publications

References 5 publications

Identification and mapping of worldwide sources of generic real‐world data

Identification and mapping of worldwide sources of generic real‐world data

Comparison of risk adjustment methods in patients with liver disease using electronic medical record data

Hepatitis B patients exhibiting mild alanine aminotransferase elevation: A comparative analysis of treatment with and without Bicyclol tablets

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