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Finding “truth” across different data sources

机译:跨不同数据源查找“真相”

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The proliferation of new technology platforms and tools is dramatically advancing our ability to capture, integrate and use clinical and other health related data for research and care. Another critical and increasingly common source of data comes directly from patients – often in the form of Patient Reported Outcomes (PRO). As more providers and payers recognize that patient experiences reflect a critical dimension of the value proposition, these data are informing broader strategies to achieve performance improvement and accountability in health systems. Combined with other traditional (e.g., claims) and more recent (e.g., Electronic Health Record) data assets, PROs can help to examine experiences and outcomes that convey a more complete picture of both individual and population health. One of the areas of research where this is most evident is cancer survivorship, including long-term adverse effects, as the population of survivors is increasing given advances in?detection and?treatment.Key questions remain as to how and under what conditions these new data resources can be used for research, and which are the best “sources of truth” for specific types of information. A recent IJHPR validation study by Hamood et al. reflects important progress in this regard, and establishes the necessary groundwork for a larger planned study. There are some important limitations worth noting, such as a small sample size (which does not support adequate subgroup analysis); a relatively narrow focus on women with only early stage or regionally advanced breast cancer; and a limited focus on outcomes that are primarily clinical and relatively severe in nature (e.g., cardiovascular disease).Finally, as use of EHRs becomes ubiquitous, as patient perspectives and outcome measures are considered, and as more types of data are systematically collected via electronic systems, further comparison and validation of non-clinical data elements captured via such tools will become increasingly possible and important. This will further enhance the capacity of cancer survivorship researchers to address a broader range of important questions to many more types of patients.
机译:新技术平台和工具的激增极大地提高了我们捕获,整合和使用临床及其他健康相关数据进行研究和护理的能力。另一个重要且日益普遍的数据来源直接来自患者-通常采用患者报告结果(PRO)的形式。随着越来越多的提供者和付款人认识到患者的经历反映了价值主张的一个关键方面,这些数据为更广泛的战略提供了信息,以实现医疗系统的绩效改善和问责制。 PRO与其他传统(例如索赔)和较新的(例如电子健康记录)数据资产相结合,可以帮助检查经验和结果,从而更全面地反映个人和人群的健康状况。最明显的研究领域之一是癌症的生存率,包括长期不良反应,因为随着检测和治疗的发展,幸存者的数量正在增加。这些新的方法和条件在关键问题上仍然存在。数据资源可用于研究,对于特定类型的信息,这是最好的“真理来源”。 Hamood等人最近进行的IJHPR验证研究。反映了这方面的重要进展,并为更大的计划研究奠定了必要的基础。有一些值得注意的重要限制,例如样本量小(不支持足够的亚组分析);相对狭窄地关注仅患有早期或区域晚期乳腺癌的妇女;最后,随着EHR的使用变得无处不在,考虑到患者的观点和结果测量方法,并且随着越来越多的系统地收集数据类型,人们开始广泛使用EHRs。在电子系统中,通过此类工具捕获的非临床数据元素的进一步比较和验证将变得越来越可能和重要。这将进一步提高癌症幸存者研究人员向更多类型的患者解决更广泛的重要问题的能力。

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