We chose 5 years retrospective entries for Read Codes because we had been
paperless for 6 years at the time of the study. Thus the practice EPR
system should have been valid for the whole of this time. We searched for
Read coded entries for the test conditions during the study period and
compared this to specific (drug) treatments, diagnostic tests and
procedure codes to validate the entry for each test condition. We included
conditions with a matching entry made during the study period. This would
only include conditions that were more than five years old where there was
an entry about that condition during the 5 year study period. The same
criteria applied to the drug searches.
We think the contingency tables for breast and prostate cancer are
correct. This is because that entries about these 2 conditions could still
be made in the wrong records (male or female), so validation must include
all active records within the EPR system. We were also aware that 1% of
breast cancer occurs in men.
As a training practice ourselves, we are also interested in the
application of our study to training practice reapproval. It may well be
that some form of validation or audit of "paperless" training practice EPR
systems will become a necessary part of that process. However, at this
stage, a review of processes rather than outcomes might seem a reasonable
basis for training practice reapproval.
Rapid Response:
Re: Trying it out.
In response to Dr Phil Hughes:
We chose 5 years retrospective entries for Read Codes because we had been
paperless for 6 years at the time of the study. Thus the practice EPR
system should have been valid for the whole of this time. We searched for
Read coded entries for the test conditions during the study period and
compared this to specific (drug) treatments, diagnostic tests and
procedure codes to validate the entry for each test condition. We included
conditions with a matching entry made during the study period. This would
only include conditions that were more than five years old where there was
an entry about that condition during the 5 year study period. The same
criteria applied to the drug searches.
We think the contingency tables for breast and prostate cancer are
correct. This is because that entries about these 2 conditions could still
be made in the wrong records (male or female), so validation must include
all active records within the EPR system. We were also aware that 1% of
breast cancer occurs in men.
As a training practice ourselves, we are also interested in the
application of our study to training practice reapproval. It may well be
that some form of validation or audit of "paperless" training practice EPR
systems will become a necessary part of that process. However, at this
stage, a review of processes rather than outcomes might seem a reasonable
basis for training practice reapproval.
Competing interests: No competing interests