Weighted EHR-based prevalence estimates for hypertension at the state and local levels in Louisiana
Weighted EHR-based prevalence estimates for hypertension at the state and local levels in Louisiana
Blog Article
Abstract Background Modernization of public health data systems is a national priority.Improved chronic disease surveillance can provide more timely, GLOSSY LIPSTICK PEONY DEW #505 accurate, and local measures to inform public health policy and intervention.Although electronic health record (EHR) data have great potential for surveillance, population coverage is non-random, which may result in biased estimates.Statistical approaches are needed to adjust estimates to represent the underlying population and validate the results against independent estimates.
Methods MENDS, the Multi-State-EHR-Based Network for Disease Surveillance, uses EHR data to calculate chronic disease and risk factor prevalence metrics.In this study, we applied post-stratification weighting to MENDS data from nearly 800,000 adults from Louisiana to estimate the prevalence of hypertension and hypertension control at the state and parish (county-equivalent) levels during February 2023.We then compared weighted MENDS hypertension prevalence estimates with measures derived from traditional public health surveillance.Results Weighted MENDS hypertension prevalence estimates were approximately 10% lower than crude MENDS estimates, and approximately 13% higher than hypertension awareness estimates from the 2021 Behavioral Risk Factor Surveillance System, with similar geographic and demographic patterns.
Weighted MENDS hypertension prevalence estimates indicated that 43.0% of Louisiana adult residents had hypertension (versus 47.7% crude prevalence).Prevalence was higher than the overall state estimate among men (47.
3% weighted; 55.9% crude), RICE MAC Black patients (50.2% weighted; 55.7% crude), those receiving Medicare (70.
6% weighted; 76.2% crude), and individuals living in rural areas (46.1% weighted; 49.8% crude).
Hypertension prevalence increased with age and with more clinical visits during the previous 2 years.Hypertension prevalence was highest in the southeastern parishes near New Orleans and Baton Rouge.Demographic and geographic patterns in prevalence of hypertension control were like hypertension prevalence.Conclusions Post-stratification weighting of MENDS data brought EHR-based data estimates closer to survey-based estimates of hypertension and can improve representativeness of chronic disease indicators.
These estimates can provide public health organizations with timely, accurate, and local information.Further, EHR-based systems can produce unique measures, such as the prevalence of hypertension control, which can provide a more nuanced understanding of community needs and help public health agencies evaluate the effectiveness of community interventions.