Michalik Daniel E, Taylor Bradley W, Panepinto Julie A
Medical College of Wisconsin/The Children's Research Institute of the Children's Hospital of Wisconsin, Pediatric Hematology/Oncology/Bone Marrow Transplant, Milwaukee.
Clinical and Translational Science Institute of Southeastern Wisconsin, Milwaukee.
Acad Pediatr. 2017 Apr;17(3):283-287. doi: 10.1016/j.acap.2016.12.005. Epub 2016 Dec 13.
To develop and validate a computable phenotype algorithm for identifying patient populations with sickle cell disease.
In this retrospective study we used electronic health record data from the Children's Hospital of Wisconsin to develop a computable phenotype algorithm for sickle cell disease. The algorithm was on the basis of the International Classification of Diseases, Ninth Revision codes, number of visits, and hospital admissions for sickle cell disease. Using Informatics for Integrating Biology and the Bedside queries, the algorithm was refined in an iterative process. The final algorithm was verified using manual medical records review and by comparison with a gold standard set of confirmed sickle cell cases. The algorithm was then validated at Froedtert Hospital, a neighboring health system for adults.
From the Children's Hospital of Wisconsin, our computable phenotype algorithm identified patients with confirmed sickle cell disease with a positive predictive value of 99.4% and a sensitivity of 99.4%. Additionally, using data from Froedtert, the computable phenotype algorithm identified patients with confirmed sickle cell disease with a positive predictive value of 95.8% and a sensitivity of 98.3%.
The computable phenotype algorithm developed in this study had a high sensitivity and positive predictive value when identifying patients with sickle cell disease in the electronic health records of the Children's Hospital of Wisconsin and Froedtert, a neighboring health system for adults. Our algorithm allows us to harness data provided by the electronic health record to rapidly and accurately identify patient with sickle cell disease and is a rich resource for future clinical trials.
开发并验证一种用于识别镰状细胞病患者群体的可计算表型算法。
在这项回顾性研究中,我们使用了威斯康星儿童医院的电子健康记录数据来开发一种镰状细胞病的可计算表型算法。该算法基于国际疾病分类第九版编码、就诊次数以及镰状细胞病的住院次数。通过整合生物学与床边信息学查询,该算法在一个迭代过程中得到完善。最终算法通过人工病历审查以及与一组确诊镰状细胞病的金标准病例进行比较来验证。然后在邻近的成人健康系统弗罗伊德特医院对该算法进行验证。
在威斯康星儿童医院,我们的可计算表型算法识别出确诊镰状细胞病患者,其阳性预测值为99.4%,灵敏度为99.4%。此外,利用弗罗伊德特医院的数据,该可计算表型算法识别出确诊镰状细胞病患者,其阳性预测值为95.8%,灵敏度为98.3%。
本研究中开发的可计算表型算法在识别威斯康星儿童医院和邻近的成人健康系统弗罗伊德特医院电子健康记录中的镰状细胞病患者时,具有较高的灵敏度和阳性预测值。我们的算法使我们能够利用电子健康记录提供的数据快速准确地识别镰状细胞病患者,并且是未来临床试验的丰富资源。