Comparing prescribing and dispensing databases to study antibiotic use: a validation study of the Electronic Medical Record Administrative data Linked Database (EMRALD)
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Le résumé fourni par la source
BACKGROUND: Monitoring and studying community antibiotic use is a critical component in combating rising antimicrobial resistance. OBJECTIVES: To validate an electronic medical record dataset containing antibiotic prescriptions and to quantify some important differences between prescribing and dispensing databases. METHODS: We evaluated antibiotics prescribed and dispensed to patients ≥65 years of age during 2011-15. We compared the EMRALD prescribing database with the validated Ontario Drug Benefit (ODB) dispensing database. Using ODB as the gold standard and limiting to EMRALD physicians, we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with 95% CIs. We also compared the relative change in antibiotic use prescribed by all physicians to this population over time between the databases using Poisson regression models. RESULTS: In this population, 74% of all antibiotics dispensed were from non-EMRALD physicians. Trends in use were discordant over time. When we limited ODB to EMRALD prescribers only to assess the validity of EMRALD data, we observed good sensitivity and excellent specificity for correctly identifying antibiotics at 85% (95% CI 84%-85%) and 98% (95% CI 98%-98%), respectively. The PPV was 78% (95% CI 78%-78%) and the NPV was 99% (95% CI 99%-99%). All performance measures were higher among the highest prescribing physicians. CONCLUSIONS: We demonstrated EMRALD is well suited for studying antibiotic prescribing by EMRALD physicians. However, due to the frequency with which patients receive antibiotic prescriptions from their non-primary care physicians, we caution against the use of non-population-based prescribing databases to infer antibiotic use rates or trends over time.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Comparing prescribing and dispensing databases to study antibiotic use: a validation study of the Electronic Medical Record Administrative data Linked Database (EMRALD)
- Date Crossref
- 25/02/2019
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Toronto The Institute of Health Policy pays non établi dans la noticeUniversité ou école supérieure
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St Joseph's Health Centre pays non établi dans la noticeÉtablissement de santé
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Public Health Ontario pays non établi dans la noticeÉtablissement de santé
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Institute for Clinical Evaluative Sciences pays non établi dans la noticeOrganisation à but non lucratif
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Sunnybrook Health Science Centre pays non établi dans la noticeÉtablissement de santé
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Health Sciences Centre pays non établi dans la noticeÉtablissement de santé
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University Health Network Toronto Western Hospital Family Health Team pays non établi dans la noticeÉtablissement de santé
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Toronto Western Hospital pays non établi dans la noticeÉtablissement de santé
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Dalla Lana School of Public Health pays non établi dans la noticeUniversité ou école supérieure
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ICES pays non établi dans la noticeInstitution
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St. Joseph’s Health Centre pays non établi dans la noticeÉtablissement de santé
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Ottawa Research Institute pays non établi dans la noticeStructure de recherche
The Institute of Health Policy — University of Toronto, St Joseph's Health Centre et Public Health Ontario, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.