A New Validated Approach for Identifying Childhood Immunizations in Electronic Health Records in the United Kingdom.

Autor: Suffel AM; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.; NIHR Health Protection Research Unit in Vaccines and Immunisation at London School of Hygiene and Tropical Medicine, London, UK., Walker JL; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.; NIHR Health Protection Research Unit in Vaccines and Immunisation at London School of Hygiene and Tropical Medicine, London, UK.; UK Health Security Agency, London, UK., Campbell C; UK Health Security Agency, London, UK., Carreira H; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK., Warren-Gash C; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK., McDonald HI; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.; NIHR Health Protection Research Unit in Vaccines and Immunisation at London School of Hygiene and Tropical Medicine, London, UK.; Department of Life Science, University of Bath, Bath, UK.
Jazyk: angličtina
Zdroj: Pharmacoepidemiology and drug safety [Pharmacoepidemiol Drug Saf] 2024 Aug; Vol. 33 (8), pp. e5848.
DOI: 10.1002/pds.5848
Abstrakt: Background: Routinely collected electronic health records (EHR) offer a valuable opportunity to carry out research on immunization uptake, effectiveness, and safety, using large and representative samples of the population. In contrast to other drugs, vaccines do not require electronic prescription in many settings, which may lead to ambiguous coding of vaccination status and timing.
Methodology: We propose a comprehensive algorithm to identifying childhood immunizations in routinely collected EHR. In order to deal with ambiguous coding, over-recording, and backdating in EHR, we suggest an approach combining a wide range of medical codes in combination to identify vaccination events and using appropriate wash-out periods and quality checks. We illustrate this approach on a cohort of children born between 2006 and 2014 followed up to the age of five in the Clinical Practice Research Datalink (CPRD) Aurum, a UK primary care dataset of EHR, and validate the results against national estimates of vaccine coverage by NHS Digital and Public Health England.
Results: Our algorithm reproduced estimates of vaccination coverage, which are comparable to official national estimates and allows to approximate the age at vaccination. Electronic prescription data only do not cover vaccination events sufficiently.
Conclusion: Our new proposed method could be used to provide a more accurate estimation of vaccination coverage and timing of vaccination for researchers and policymakers using EHR. As with all observational research using real-world data, it is important that researchers understand the context of the used dataset used and the clinical practice of recording.
(© 2024 The Author(s). Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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