Using electronic medical records to analyze outpatient visits of persons with epilepsy during the pandemic——experience from a low middle income country  

作　　者：Rajeswari Aghoram Pradeep P.Nair Anudeep Neelagandan 

机构地区：[1]Neurology,Super Specialty Block,Jawaharlal Institute of Postgraduate Medical Education and Research,Pondicherry 605006,India [2]Hospital information systems,Jawaharlal Institute of Postgraduate Medical Education and Research,Pondicherry 605006,India

出　　处：《Acta Epileptologica》2025年第1期78-85,共8页癫痫学报(英文)

基　　金：supported by the Indian Council of Medical Research,New Delhi,India.(RFC No.ECD/Adhoc/87/2021–2022;2022).

摘　　要：Background Electronic medical records(EMR)can be utilized to understand the impact of the disruption in care provision caused by the pandemic.We aimed to develop and validate an algorithm to identify persons with epilepsy(PWE)from our EMR and to use it to explore the effect of the pandemic on outpatient service utilization.Methods EMRs from the neurology specialty,covering the period from January 2018 to December 2023,were used.An algorithm was developed using an iterative approach to identify PWE with a critical lower bound of 0.91 for negative predictive value.Manual internal validation was performed.Outpatient visit data were extracted and modeled as a time series using the autoregressive integrated moving average model.All statistical analyses were performed using STATA version 14.2(Statacorp,USA).Results Four iterations resulted in an algorithm,with a negative predictive value 0.98(95%CI:0.95–0.99),positive predictive value of 0.98(95%CI:0.85–0.99),and an F-score accuracy of 0.96,which identified 4474 PWE.The outpatient service utilization was abruptly reduced by the pandemic,with a change of-902.1(95%CI:-936.55 to-867.70),and the recovery has also been slow,with a decrease of-5.51(95%CI:-7.00 to-4.02).Model predictions aligned closely with actual visits with median error of-3.5%.Conclusions We developed an algorithm for identifying people with epilepsy with good accuracy.Similar methods can be adapted for use in other resource-limited settings and for other diseases.The COVID pandemic appears to have caused a lasting reduction of service utilization among PWE.

关 键 词：Electronic medical records Manual validation Interrupted time series analysis 

分 类 号：R74[医药卫生—神经病学与精神病学]