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Formalization and computation of quality measures based on electronic medical records
Vrije University of Amsterdam, Netherlands University of Amsterdam, Netherlands .
University of Medical Centre Utrecht, Netherlands Vrije University of Amsterdam, Netherlands .
Vrije University of Amsterdam, Netherlands .
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology. University of Amsterdam, Netherlands.
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2014 (English)In: JAMIA Journal of the American Medical Informatics Association, ISSN 1067-5027, E-ISSN 1527-974X, Vol. 21, no 2, 285-291 p.Article in journal (Refereed) Published
Abstract [en]

Objective Ambiguous definitions of quality measures in natural language impede their automated computability and also the reproducibility, validity, timeliness, traceability, comparability, and interpretability of computed results. Therefore, quality measures should be formalized before their release. We have previously developed and successfully applied a method for clinical indicator formalization (CLIF). The objective of our present study is to test whether CLIF is generalizablethat is, applicable to a large set of heterogeneous measures of different types and from various domains. Materials and methods We formalized the entire set of 159 Dutch quality measures for general practice, which contains structure, process, and outcome measures and covers seven domains. We relied on a web-based tool to facilitate the application of our method. Subsequently, we computed the measures on the basis of a large database of real patient data. Results Our CLIF method enabled us to fully formalize 100% of the measures. Owing to missing functionality, the accompanying tool could support full formalization of only 86% of the quality measures into Structured Query Language (SQL) queries. The remaining 14% of the measures required manual application of our CLIF method by directly translating the respective criteria into SQL. The results obtained by computing the measures show a strong correlation with results computed independently by two other parties. Conclusions The CLIF method covers all quality measures after having been extended by an additional step. Our web tool requires further refinement for CLIF to be applied completely automatically. We therefore conclude that CLIF is sufficiently generalizable to be able to formalize the entire set of Dutch quality measures for general practice.

Place, publisher, year, edition, pages
BMJ Publishing Group / Elsevier , 2014. Vol. 21, no 2, 285-291 p.
Keyword [en]
Quality Measures; Quality Indicators; Electronic Medical Record; Secondary Use of Patient Data; Identification of Patient Cohorts; EMR-driven Phenotyping
National Category
Engineering and Technology
URN: urn:nbn:se:liu:diva-105749DOI: 10.1136/amiajnl-2013-001921ISI: 000331263600015OAI: diva2:710329
Available from: 2014-04-07 Created: 2014-04-04 Last updated: 2014-05-13

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