November 13, 2006Archives of Internal Medicine
Assessing the Validity of National Quality Measures for Coronary Artery Disease Using an Electronic Health Record
Key result
Supplementing automated EHR measurement with free-text note review for CAD quality measures revealed that 15% to 81% of apparent failures were misclassified, improving adherence rates up to 99.2%.
Why the study?
Does supplementing automated EHR measurement with free-text note review improve the accuracy of quality performance measures in patients with CAD?
Population
Patients with coronary artery disease (CAD) from a large internal medicine practice
Comparison
2-step process of automated measurement… vs Automated measurement alone
Design
Cohort
Authors
Discussion
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Member takes
Implication
Automated EHR CAD metrics may underestimate performance; leaves open whether routine note review or better structured data should be adopted.
Study Design
Type
Observational
Multicenter
No
Structured PICO
Does supplementing automated EHR measurement with free-text note review improve the accuracy of quality performance measures in patients with CAD?
P
Population
Patients with coronary artery disease (CAD) from a large internal medicine practice
I
Intervention
2-step process of automated measurement supplemented by review of free-text notes for apparent quality failures
C
Comparator
Automated measurement alone
O
Outcome
Adherence rate to 7 performance measures for CAD
Automated EHR-based quality measurement for CAD care significantly underestimates true performance due to misclassification, highlighting the need for improved data recording or free-text review.
Limitations
- Profiling the quality of outpatient CAD care using data from an EHR has significant limitations
- Changes in how data are routinely recorded in an EHR are needed to improve accuracy
- Validity testing in different settings is required
Cite This Study
Stephen D. Persell (2006) conducted an observational in Coronary artery disease (CAD). Automated measurement supplemented by review of free-text notes vs. Automated measurement alone was evaluated on Validity of performance measures for CAD (adherence rate). Supplementing automated EHR measurement with free-text note review for CAD quality measures revealed that 15% to 81% of apparent failures were misclassified, improving adherence rates up to 99.2%.