Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies.

Autor: Mohamed HH; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA., Ehresmann K; Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota, USA., Seburg EM; Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota, USA., Vazquez-Benitez G; Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota, USA., Demerath EW; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA., Fields DA; Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA., Vesco KK; Kaiser Permanente Center for Health Research, Portland, Oregon, USA., Kharbanda EO; Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota, USA., Palmsten K; Pregnancy and Child Health Research Center, HealthPartners Institute, Minneapolis, Minnesota, USA.
Jazyk: angličtina
Zdroj: Paediatric and perinatal epidemiology [Paediatr Perinat Epidemiol] 2024 Aug; Vol. 38 (6), pp. 505-514. Date of Electronic Publication: 2024 Mar 17.
DOI: 10.1111/ppe.13051
Abstrakt: Background: Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care.
Objectives: To characterise breastfeeding information recorded in structured fields in EHR during infant and postpartum health care visits, and to assess the validity of lactation status based on EHR data versus maternal report at research study visits.
Methods: We assessed breastfeeding information recorded in structured fields in EHR from one health system for a subset of 211 patients who were also enrolled in a study on breast milk composition between 2014 and 2017 that required participants to exclusively breastfeed their infants until at least 1 month of age. We assessed the frequency of breastfeeding information in EHR during the first 12 months of age and compared lactation status based on EHR with maternal report at 1 and 6-month study visits (reference standard).
Results: The median number of breastfeeding records in the EHR per infant was six (interquartile range 3) with most observations clustering in the first few weeks of life and around well-infant visits. At the 6-month study visit, 93.8% of participants were breastfeeding and 80.1% were exclusively breastfeeding according to maternal report. Sensitivity of EHR data for identifying ever breastfeeding was at or near 100%, and sensitivity for identifying ever exclusive breastfeeding was 98.0% (95% CI: 95.0%, 99.2%). Sensitivities were 97.3% (95% CI: 93.9%, 98.9%) for identifying any breastfeeding and 94.4% (95% CI: 89.7%, 97.0%) for exclusive breastfeeding, and positive predictive values were 99.5% (95% CI: 97.0%, 99.9%) for any breastfeeding and 95.0% (95% CI: 90.4%, 97.4%) for exclusive breastfeeding.
Conclusions: Breastfeeding information in structured EHR fields have the potential to accurately classify lactation status. The validity of these data should be assessed in populations with a lower breastfeeding prevalence.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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