The interpretation of the reasons for encounter ‘cough’ and ‘sadness’ in four international family medicine populations

Journal of Innovation in Health Informatics

Kes van Boven¹  Milan Jevtic²  Jean K Soler³  Frank Dobbs³  Sibo Oskam⁴  Predrag Zivotic⁵  Inge Okkes⁶  Henk Lamberts⁶ 

[1] Department of Primary and Community Care, Nijmegen Medical Centre, Radboud University, the Netherlands;Deputy Executive Director, Saga System Integration, Belgrade, Serbia;Faculty of Life and Health Sciences, University of Ulster, Coleraine, UK and Mediterranean Institute of Primary Care, Attard, Malta;Formerly of the Department of General Practice, University of Amsterdam, the Netherlands;Health Information Unit Manager, EU Hospital Health Information System Project, UNOPS, Serbia;Mediterranean Institute of Primary Care, Attard, Malta and Formerly of the Department of General Practice, University of Amsterdam, the Netherlands;

关键词: cough;    depressed;    diagnosis;    electronic medical record;    electronic patient record;    episode of care;    family medicine;    general practice;    ICPC;    International Classification of Primary Care;    international;    posterior probability;    prior probability;   

DOI  :  10.14236/jhi.v20i1.45

来源: DOAJ

【 摘 要 】

Background This is a study of the relationships between common reasons for encounter and common diagnoses (episode titles) within episodes of care in family practice populations in four countries.

Method Participating family doctors recorded details of all their patient contacts in an EoC structure using the International Classification of Primary Care, including RfEs presented by the patient, and the FDs’ diagnostic labels. The relationships between RfEs and episode titles were studied using Bayesian methods.

Results The RfE ‘cough’ is a strong, reliable predictor for the diagnoses ‘cough’, ‘acute bronchitis’, ‘URTI’ and ‘acute laryngitis/tracheitis’ and a less strong, but reliable predictor for ‘sinusitis’, ‘pneumonia’, ‘influenza’, ‘asthma’, ‘other viral diseases’, ‘whooping cough’, ‘chronic bronchitis’, ‘wheezing’ and ‘phlegm’. The absence of cough is a weak but reliable predictor to exclude a diagnosis of ‘cough’, ‘acute bronchitis’ and ‘tracheitis’. Its presence allows strong, reliable exclusion of the diagnoses ‘gastroenteritis’, ‘no disease’ and ‘health promotion/prevention’, and less strong exclusion of ‘adverse effects of medication’. The RfE ‘sadness’ is a strong, reliable predictor for the diagnoses ‘feeling sad/depressed’ and ‘depressive disorder’. It is a less strong, but reliable predictor of a diagnosis of ‘acute stress reaction’. The absence of sadness is a weak but reliable predictor to exclude the symptom diagnosis ‘feeling sad/depressed’. Its presence does not support the exclusion of any diagnosis.

Conclusions We describe clinically and statistically significant diagnostic associations observed between the RfEs ‘cough’ and ‘sadness’, presenting as a new problem in family practice, and all the episode titles in ICPC.

【 授权许可】

Unknown