Development and validation of an electronic health record-based algorithm for identifying TBI in the VA: A VA Million Veteran Program study.

The purpose of this study was to develop and validate an algorithm for identifying Veterans with a history of traumatic brain injury (TBI) in the Veterans Affairs (VA) electronic health record using VA Million Veteran Program (MVP) data. Manual chart review (n = 200) was first used to establish 'gol...

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Publicado en:Brain Injury Vol. 38; no. 13; pp. 1084 - 1093
Autores principales: Merritt, Victoria C., Chen, Alicia W., Bonzel, Clara-Lea, Hong, Chuan, Sangar, Rahul, Morini Sweet, Sara, Sorg, Scott F., Chanfreau-Coffinier, Catherine
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd 2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2024
      vid: 38
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/02699052.2024.2373920
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        atl: Development and validation of an electronic health record-based algorithm for identifying TBI in the VA: A VA Million Veteran Program study.
      aug:
        au:
          Merritt, Victoria C.
          Chen, Alicia W.
          Bonzel, Clara-Lea
          Hong, Chuan
          Sangar, Rahul
          Morini Sweet, Sara
          Sorg, Scott F.
          Chanfreau-Coffinier, Catherine
        affil: VA San Diego Healthcare System (VASDHS), San Diego, CA, USA
      sug:
        subj:
          Brain Injuries Diagnosis
          Electronic Health Records
          Algorithms Evaluation
          Veterans
          United States Department of Veterans Affairs
          Human
          Funding Source
          Male
          Female
          Adult
          Middle Age
          Aged
          Comparative Studies
          Record Review
          Descriptive Statistics
          Phenotype
          Prediction Models
          Probability
          Sensitivity and Specificity
          Predictive Value of Tests
          Surveys
          Military Health
          Veterans Health Services
          Validation Studies
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: The purpose of this study was to develop and validate an algorithm for identifying Veterans with a history of traumatic brain injury (TBI) in the Veterans Affairs (VA) electronic health record using VA Million Veteran Program (MVP) data. Manual chart review (n = 200) was first used to establish 'gold standard' diagnosis labels for TBI ('Yes TBI' vs. 'No TBI'). To develop our algorithm, we used PheCAP, a semi-supervised pipeline that relied on the chart review diagnosis labels to train and create a prediction model for TBI. Cross-validation was used to train and evaluate the proposed algorithm, 'TBI-PheCAP.' TBI-PheCAP performance was compared to existing TBI algorithms and phenotyping methods, and the final algorithm was run on all MVP participants (n = 702,740) to assign a predicted probability for TBI and a binary classification status choosing specificity = 90%. The TBI-PheCAP algorithm had an area under the receiver operating characteristic curve of 0.92, sensitivity of 84%, and positive predictive value (PPV) of 98% at specificity = 90%. TBI-PheCAP generally performed better than other classification methods, with equivalent or higher sensitivity and PPV than existing rules-based TBI algorithms and MVP TBI-related survey data. Given its strong classification metrics, the TBI-PheCAP algorithm is recommended for use in future population-based TBI research.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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