Developing electronic health record algorithms that accurately identify patients with juvenile idiopathic arthritis.

• To the best of our knowledge, this is the first study to create an EHR-based JIA cohort using ICD codes, keywords, and exclusion criteria. • Three studied algorithms achieved PPVs of 97%, each with different algorithm criteria, allowing for users to select an algorithm to best fit their research n...

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Published in:Seminars in Arthritis & Rheumatism Vol. 59
Main Authors: Peterson, Hannah M., Vela, Kelsi L., Barnado, April, Patrick, Anna E.
Format: research Journal Article
Published: W B Saunders Apr2023
Online Access:View this record in EBSCOhost
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      jtl: Seminars in Arthritis & Rheumatism
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      dt: Apr2023
      vid: 59
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        10.1016/j.semarthrit.2023.152167
        162178548
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        atl: Developing electronic health record algorithms that accurately identify patients with juvenile idiopathic arthritis.
      aug:
        au:
          Peterson, Hannah M.
          Vela, Kelsi L.
          Barnado, April
          Patrick, Anna E.
        affil: Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, United States
      sug:
        subj:
          Arthritis, Juvenile Rheumatoid Diagnosis
          Algorithms Evaluation
          Electronic Health Records
          Diagnosis, Computer Assisted
          Decision Support Techniques
          Predictive Value of Tests
          Human
          Random Sample
          Sensitivity and Specificity
          International Classification of Diseases
          Prospective Studies
          Descriptive Statistics
          Validation Studies
      ab: • To the best of our knowledge, this is the first study to create an EHR-based JIA cohort using ICD codes, keywords, and exclusion criteria. • Three studied algorithms achieved PPVs of 97%, each with different algorithm criteria, allowing for users to select an algorithm to best fit their research needs. • This methodology allows for an efficient, cost-effective way to assemble a cohort of JIA patients at a single institution or at multiple institutions. The objective of this study was to develop an algorithm that accurately identifies juvenile idiopathic arthritis (JIA) patients in the electronic health record (EHR). Algorithms were developed in a de-identified EHR by searching for a priori JIA ICD-9 (International Classification of Diseases, Ninth Revision) and ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes and JIA-related keywords. Exclusion criteria were selected to remove other autoimmune diseases. A training set of 200 patients was randomly selected from patients containing ≥1 occurrence of a JIA ICD-9 or ICD-10-CM code. Case status was determined by a rheumatology clinic note documenting a JIA diagnosis before age 20. For each algorithm, positive predictive value (PPV), sensitivity, and F-measure were determined using the training set. We developed 103 algorithms using combinations of ICD codes, keywords, and exclusion criteria. The algorithm requiring 4 or more counts of JIA ICD-9 or ICD-10-CM codes, keywords "enthesitis" and "uveitis", and exclusion of ICD-9 or ICD-10-CM codes for systemic lupus erythematosus, dermatomyositis, polymyositis, and dermatopolymyositis had the highest PPV of 97% in the training set with an F-measure of 87%. There were 1,131 JIA cases returned by this algorithm. We validated the highest performing algorithm in a separate cohort from the training set with a PPV of 92% and an F-measure of 75%. We developed and validated JIA EHR algorithms with ICD-9 and ICD-10-CM codes to accurately identify a JIA cohort. Three algorithms achieved PPVs of 97%, each with different algorithm criteria, allowing for users to select an algorithm to best fit their research needs.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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