中国鄞州电子健康档案研究项目(CHinese Electronic health Records Research in Yinzhou, CHERRY)由国家自然科学基金(91546120,81573226,91846112)和北京市自然科学基金(7162107,7182084)资助,北京大学高培教授团队和宁波市鄞州区疾病预防控制中心建立。项目基于浙江省宁波市鄞州区的区域卫生信息系统,包括人口信息数据库、健康体检信息数据库、门诊及住院病人电子病历数据库、健康保险数据库等,并整合了鄞州区疾病预防控制中心的公共卫生监测、人群筛查、疾病管理及其他健康保健服务数据,可提供鄞州区98%的常住居民的疾病及健康相关信息。
CHinese Electronic health Records Research in Yinzhou (CHERRY), funded by national natural science foundation of China (91546120,81573226,91846112) and Beijing natural science foundation (7162107,7182084) , was established by the team of Professor Gao of Peking University and the Yinzhou District Centre for Disease Control and Prevention. The project was based on the regional health information system of Yinzhou District of Ningbo in Zhejiang province, including the population information database and health check information database, inpatient and outpatient electronic medical record database, health insurance database, etc. And the project has integrated public health surveillance, population screening, disease management, health information system in hospitals and other healthcare services, which has covered nearly 98% residents’health-related information within this region.
团队介绍 Research Team
本团队隶属于北京大学公共卫生学院流行病与卫生统计学系,团队负责人为高培教授,另有团队成员共6人,包括副教授1名,博士生1名,研究生4名。高培教授具有丰富的海外著名院校科研经历,在心血管流行病和医学统计领域有多年的研究工作经验,于2015年入选第十一批国家“千人计划”青年人才,在Lancet、JAMA、Circulation等国际顶级学术期刊发表多篇SCI论文。
Our research team is composed of 7 members (1 professor, 1 associate professor, 1 doctoral candidate and 4 master candidates) from Peking University School of Public Health. The team leader, Professor Gao Pei, has rich research experience in cardiovascular epidemiology and medical statistics. She was selected as one of the eleventh national “Thousand Talents Program” in 2015, and has published many SCI papers in Lancet, JAMA, Circulation and other international academic journals.
本团队于2016年完成了对鄞州区区域公共卫生一体化平台中相关管理数据库的梳理工作,建立了CHERRY队列,研究总体设计方案已公开发表于BMJ Open(2018; 8(2):e019698).
Based on the data sources in health information system of Yinzhou district, the CHERRY study, a natural, longitudinal, population-based ambispective cohort study for outcomes research was established in 2016. The overall design of the study has been published in BMJ Open(2018; 8(2):e019698).
数据资源 Data Resource
浙江省宁波市鄞州区位于浙江省东部,截至 2016 年底共有人口 124 万,其中常驻人口 79 万,辖 25 个镇(乡、街道), 535 个行政村(社区、居委会)。投入使用综合性医院 8 家,卫生院/社区卫生服务中心 41 家,社区卫生服务站 320 家,占地面积 1346平方公里,城乡二元结构比较突出。
Yinzhou is a district of Ningbo in Zhejiang province(29°37′-29°57′ N, 121°08′-121°54′ E), located 230 km south of Shanghai, China, with an area of 1346km2. Yinzhou had a total population of 1.24million in 2016, including 790,600 permanent residents. This district has jurisdiction over 25 towns (townships, streets) and 535 administrative villages (communities and neighborhood committees). There are 8 comprehensive hospitals, 41 hospitals/health service centers, and 320 community health service stations.
浙江省宁波市鄞州区(图)为国家卫生信息化试点区域之一,宁波市鄞州区疾病预防控制中心对该地区区域卫生的信息化建设从2006 年开始发展至今已有十年历史。基于一般人群的居民 EHR 的区域卫生信息平台已经建立并运行良好。该平台的核心优势是连通了该地区所有公立医疗机构,涵盖了医院信息系统、社区卫生信息系统、人群监测系统等公共卫生信息系统中所有关键性业务数据,区域内个人健康档案与各医院电子病历系统充分共享,互联互通。至 2010年,该卫生信息平台已覆盖 98%的当地常驻人口。
This particular region is a developed area and was selected because of its outstanding general practice based primary care units and unique integrated electronic health information system. Health information systems was originally designed in 2006 by the Yinzhou District Centre for Disease Control and Prevention, which included different administrative databases of general demographic characteristics, health check information, inpatient and outpatient electronic medical records (EMRs), health insurance database, disease management and death certificates, and so on. Since 2010, this health information system has covered 98% of health-related activities of permanent residents within this region, from birth to death, including children, adolescents, pregnant women, adults and elderly people.
研究项目建立 Cohort establishment
本团队按照调查对象的唯一识别健康档案号,对鄞州区区域公共卫生一体化平台中相关管理数据库进行连接合并,生成了具有研究对象疾病患病信息与死亡信息的完整数据库。其中系统中登记的居民中符合以下标准的被纳入CHERRY研究:(1)在2009年1月1日18岁及以上;(2)有完整的出生日期、性别和有效的唯一的身份识别健康档案号;(3)在鄞州居住至少6个月;(4)中国国籍。一旦纳入 CHERRY 研究,参与者将在健康信息系统中持续随访,直到死亡或离开当地医保系统(主要是由于搬离该省)CHERRY研究每年会从系统中更新参与者的重要信息,例如临床结局、生命特征以及个体普查资料等。通过建立数据字典,统一编码规则,对多源异构数据连接过程中普遍存在的问题一一处理后,最终实现了该地区1,053,565成人新兴的基于EHR的自然人群队列的构建。
Databases in the health information systems are inherently linked to each other by a unique and encoded identifier for each individual. The study comprises all participants registered in the system if they: (1) were over 18 years of age on 1 January 2009; (2) have complete information on date of birth, sex and a valid healthcare identifier; (3) have been living in Yinzhou for at least 6 months; and (4) have Chinese nationality. Once included in the CHERRY cohort, individuals remain in it until death or termination of local health insurance (primarily owing to moving out of the province). Follow-up is generally continuous in the health information system. CHERRY will update certain important information such as vital status, clinical outcomes and claims data for all cohort members annually from the administrative databases. By drawing up the data dictionary, uniformed coding principle, solved conflicting and missing data embedded ,we established the population-based cohort, in which a total of 105 million adults were included.
卫生服务人员向群众科普健康知识 Health service personnel to the public science knowledge of the masses
健康检查现场 Health check site