J Am Med Inform Assoc - An electronic health record driven algorithm to identify incident antidepressant medication users.

Tópicos

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Resumo

JECTIVE: We validated an algorithm designed to identify new or prevalent users of antidepressant medications via population-based drug prescription records.PATIENTS AND METHODS: We obtained population-based drug prescription records for the entire Olmsted County, Minnesota, population from 2011 to 2012 (N=149,629) using the existing electronic medical records linkage infrastructure of the Rochester Epidemiology Project (REP). We selected electronically a random sample of 200 new antidepressant users stratified by age and sex. The algorithm required the exclusion of antidepressant use in the 6 months preceding the date of the first qualifying antidepressant prescription (index date). Medical records were manually reviewed and adjudicated to calculate the positive predictive value (PPV). We also manually reviewed the records of a random sample of 200 antihistamine users who did not meet the case definition of new antidepressant user to estimate the negative predictive value (NPV).RESULTS: 161 of the 198 subjects electronically identified as new antidepressant users were confirmed by manual record review (PPV 81.3%). Restricting the definition of new users to subjects who were prescribed typical starting doses of each agent for treating major depression in non-geriatric adults resulted in an increase in the PPV (90.9%). Extending the time windows with no antidepressant use preceding the index date resulted in only modest increases in PPV. The manual abstraction of medical records of 200 antihistamine users yielded an NPV of 98.5%.CONCLUSIONS: Our study confirms that REP prescription records can be used to identify prevalent and incident users of antidepressants in the Olmsted County, Minnesota, population.

Resumo Limpo

jectiv valid algorithm design identifi new preval user antidepress medic via populationbas drug prescript recordspati method obtain populationbas drug prescript record entir olmst counti minnesota popul n use exist electron medic record linkag infrastructur rochest epidemiolog project rep select electron random sampl new antidepress user stratifi age sex algorithm requir exclus antidepress use month preced date first qualifi antidepress prescript index date medic record manual review adjud calcul posit predict valu ppv also manual review record random sampl antihistamin user meet case definit new antidepress user estim negat predict valu npvresult subject electron identifi new antidepress user confirm manual record review ppv restrict definit new user subject prescrib typic start dose agent treat major depress nongeriatr adult result increas ppv extend time window antidepress use preced index date result modest increas ppv manual abstract medic record antihistamin user yield npv conclus studi confirm rep prescript record can use identifi preval incid user antidepress olmst counti minnesota popul

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