155 Is the widespread adoption of interconnected electronic health records (EHR’s) contributing to the overdiagnosis problem? Establishing a research agenda
Notice bibliographique
Résumé
<h3></h3> Justification for the Proposed Workshop: As more medical practices adopt the use of interconnected Electronic Health Records (EHR’s), the issue of overdiagnosis may become increasingly impactful as a single EHR may be accessed by multiple care providers in distinct clinical settings, each with variable pre-existing relationships to the patient. In such contexts, overdiagnosed conditions applied to a patient’s problem list may result in unintended downstream consequences in excess of those that might be expected from the use of more traditional, site-specific paper charts. As such, the widespread use of interconnected EHR’s may exacerbate long-term patient labelling associated with an overdiagnosed condition. Evidencing the need for caution regarding overdiagnosis and the use of EHR’s are studies which have previously shown that patients who have had a misdiagnosed and/or overdiagnosed antibiotic hypersensitivity applied to their EHR are less likely to receive optimal therapy in the future and are therefore exposed to potentially worse clinical outcomes. Following the recent inclusion of the term ‘overdiagnosis’ to the list of searchable medical subject headings (MeSH) of the US National Library of Medicine, researchers are now able to research the topic of overdiagnosis more efficiently. We propose that a workshop be conducted to draw upon the collective knowledge Preventing Overdiagnosis 2022 Conference attendees with the goal of formalizing a proposed research agenda for topics related to how the use of EHR’s may be contributing to the overdiagnosis problem. As a team of facilitators, the authors of this proposal would plan to lead the attendees of this workshop into separate breakout group discussions each aimed at exploring suggested research topics and their associated ethical considerations. Suggested Topics for Discussion: What might patient preferences be regarding the duration that a diagnosis remains on the patient’s problem list? Might these preferences change depending on the diagnosis? Should approaches be adopted to limit the lifespan of a diagnostic label within an EHR? What are the potential benefits of a diagnostic label persisting indefinitely within a patient’s EHR? What are the potential harms of a diagnostic label persisting indefinitely within a patient’s EHR? Projected Outcomes of the Proposed Workshop: Attendees will gather an increased understanding of this topic through direct discussion with colleagues and subject-matter-experts. The authors of this proposal would collect the deliberations and conclusions accumulated through this interactive workshop to develop a commentary for publication outlining the specific agenda-items suggested for future research.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,042 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,005 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».