Evaluation of structured data from electronic health records to identify clinical classification criteria attributes for systemic lupus erythematosus
| Autor: | Andy Yizhou Wu, Karen Mancera-Cuevas, Ryan Schusler, Vesna Mitrovic, Theresa L. Walunas, Abel N. Kho, Jennifer A. Pacheco, Anh H Chung, Kathryn L. Jackson, Rosalind Ramsey-Goldman, Yuan Luo, Daniel L Erickson, Anika S Ghosh |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Immunology Disease Sensitivity and Specificity systemic lupus erythematosus Rheumatology Rheumatic Diseases Epidemiology medicine Electronic Health Records Humans Lupus Erythematosus Systemic Medical physics autoimmune diseases Systemic lupus erythematosus business.industry General Medicine Gold standard (test) RC581-607 Precision medicine medicine.disease Epidemiology and Outcomes United States Cohort epidemiology Female Diagnosis code Immunologic diseases. Allergy business Rheumatism |
| Zdroj: | Lupus Science & Medicine Lupus Science and Medicine, Vol 8, Iss 1 (2021) |
| ISSN: | 2053-8790 |
| Popis: | ObjectiveOur objective was to develop algorithms to identify lupus clinical classification criteria attributes using structured data found in the electronic health record (EHR) and determine whether they could be used to describe a cohort of people with lupus and discriminate them from a defined healthy control cohort.MethodsWe created gold standard lupus and healthy patient cohorts that were fully adjudicated for the American College of Rheumatology (ACR), Systemic Lupus International Collaborating Clinics (SLICC) and European League Against Rheumatism/ACR (EULAR/ACR) classification criteria and had matched EHR data. We implemented rule-based algorithms using structured data within the EHR system for each attribute of the three classification criteria. Individual criteria attribute and classification criteria algorithms as a whole were assessed over our combined cohorts and the overall performance of the algorithms was measured through sensitivity and specificity.ResultsIndividual classification criteria attributes had a wide range of sensitivities, 7% (oral ulcers) to 97% (haematological disorders) and specificities, 56% (haematological disorders) to 98% (photosensitivity), but all could be identified in EHR data. In general, algorithms based on laboratory results performed better than those primarily based on diagnosis codes. All three classification criteria systems effectively distinguished members of our case and control cohorts, but the SLICC criteria-based algorithm had the highest overall performance (76% sensitivity, 99% specificity).ConclusionsIt is possible to characterise disease manifestations in people with lupus using classification criteria-based algorithms that assess structured EHR data. These algorithms may reduce chart review burden and are a foundation for identifying subpopulations of patients with lupus based on disease presentation to support precision medicine applications. |
| Databáze: | OpenAIRE |
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