Development and Validation of Algorithms for Systemic Sclerosis Identification in Electronic Health Record Data.

Objective: The aim of this study was to develop and validate International Classification of Diseases (ICD) code–based algorithms for identifying systemic sclerosis (SSc) cases within electronic health record (EHR) data and to evaluate algorithm performance. Methods: We identified patients with at l...

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Publicado en:ACR Open Rheumatology Vol. 8; no. 6; pp. 1 - 6
Autores principales: Ozen, Gulsen, O'Rorke, Michael, Romitti, Paul, Domsic, Robyn
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2026
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: ACR Open Rheumatology
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      dt: Jun2026
      vid: 8
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        194918913
        194918913
        194918913
        10.1002/acr2.90091
        194918913
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        atl: Development and Validation of Algorithms for Systemic Sclerosis Identification in Electronic Health Record Data.
      aug:
        au:
          Ozen, Gulsen
          O'Rorke, Michael
          Romitti, Paul
          Domsic, Robyn
        affil: Division of Immunology and Rheumatology, Carver College of Medicine, University of Iowa, Iowa City
      sug:
        subj:
          Scleroderma, Systemic Diagnosis
          Electronic Health Records
          International Classification of Diseases
          Program Development
          Program Evaluation
          Algorithms
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Retrospective Design
          Prospective Studies
          Data Analysis Software
          ROC Curve
          Confidence Intervals
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objective: The aim of this study was to develop and validate International Classification of Diseases (ICD) code–based algorithms for identifying systemic sclerosis (SSc) cases within electronic health record (EHR) data and to evaluate algorithm performance. Methods: We identified patients with at least one ICD, Ninth Revision (ICD‐9)/ICD‐10 code for SSc in a large multicenter EHR dataset (TriNetX Research Network). A random sample of patients underwent detailed medical record review to confirm SSc diagnosis (gold standard). All ICD‐9/10 codes assigned during inpatient or outpatient encounters and corresponding dates were extracted. SSc case status derived from seven prespecified algorithms was compared with the gold standard by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic analyses. Results: Medical records from 549 of 1,098 patients with at least one SSc ICD‐9/10 code were reviewed; 399 (72.7%) were confirmed SSc cases. The algorithm requiring at least two outpatient ICD‐9/10 SSc codes at least 30 days apart with exclusion of scleroderma mimics within 24 months demonstrated the best overall performance (sensitivity 96%, specificity 71%, PPV 90%, NPV 87%, and area under the curve 0.91). Algorithms based on at least one inpatient ICD‐9/10 code showed high specificity (91%) and PPV (93%) but poor sensitivity (45%) and NPV (38%). Adding inpatient codes to the outpatient code–based algorithms did not improve performance. Conclusion: An algorithm requiring at least two outpatient SSc ICD‐9/10 codes ≥30 days apart without scleroderma mimics within 24 months reliably identifies SSc cases. This readily implementable approach outperforms previously published more complex algorithms and supports valid clinical and epidemiologic research in large datasets.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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