Development of a computable phenotype using electronic health records for venous thromboembolism in medical inpatients: the Medical Inpatient Thrombosis and Hemostasis study

被引：4

作者：

Thomas, Ryan M. ^{[1
,2
]}

Wilkinson, Katherine ^{[3
]}

Koh, Insu ^{[3
]}

Li, Ang ^{[4
]}

Warren, Janine S. A. ^{[1
]}

Roetker, Nicholas S. ^{[5
]}

Smith, Nicholas L. ^{[6
,7
,8
]}

Holmes, Chris E. ^{[1
,2
]}

Plante, Timothy B. ^{[1
,2
]}

Repp, Allen B. ^{[1
,2
]}

Cushman, Mary ^{[1
,2
]}

Zakai, Neil A. ^{[1
,2
,9
]}

机构：

[1] Univ Vermont, Larner Coll Med, Dept Med, Burlington, VT USA

[2] Univ Vermont, Med Ctr, Burlington, VT USA

[3] Univ Vermont, Larner Coll Med, Dept Pathol & Lab Med, Burlington, VT USA

[4] Baylor Univ, Med Ctr, Dept Med, Houston, TX USA

[5] Hennepin Healthcare Res Inst, Chron Dis Res Grp, Minneapolis, MN USA

[6] Univ Washington, Dept Epidemiol, Seattle, WA USA

[7] Kaiser Permanente Washington, Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USA

[8] Seattle Epidemiol Res & Informat Ctr, Dept Vet Affairs fice Res & Dev, Seattle, WA USA

[9] Univ Vermont, Larner Coll Med, Colchester Res Facil, 360 South Pk Dr, Colchester, VT 05446 USA

来源：

RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS | 2023年 / 7卷 / 04期

基金：

美国国家卫生研究院;

关键词：

International Classi; fication of Diseases; predictive value of; tests; venous thromboembolism; CODES; ACCURACY; VALIDITY; CARE;

D O I：

10.1016/j.rpth.2023.100162

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Accurate and efficient methods to identify venous thromboembolism (VTE) events in hospitalized people are needed to support large-scale studies. Validated computable phenotypes using a specific combination of discrete, searchable elements in electronic health records to identify VTE and distinguish between hospital-acquired (HA)-VTE and present-on-admission (POA)-VTE would greatly facilitate the study of VTE, obviating the need for chart review. Objectives: To develop and validate computable phenotypes for POA-and HA-VTE in adults hospitalized for medical reasons. Methods: The population included admissions to medical services from 2010 to 2019 at an academic medical center. POA-VTE was defined as VTE diagnosed within 24 hours of admission, and HA-VTE as VTE identified more than 24 hours after admission. Using discharge diagnosis codes, present-on-admission flags, imaging procedures, and medication administration records, we iteratively developed computable phenotypes for POA-VTE and HA-VTE. We assessed the performance of the phenotypes using manual chart review and survey methodology. Results: Among 62,468 admissions, 2693 had any VTE diagnosis code. Using survey methodology, 230 records were reviewed to validate the computable phenotypes. Based on the computable phenotypes, the incidence of POA-VTE was 29.4 per 1000 admissions and that of HA-VTE was 3.6 per 1000 admissions. The POA-VTE comput-able phenotype had positive predictive value and sensitivity of 88.8% (95% CI, 79.8%-94.0%) and 99.1% (95% CI, 94.0%-99.8%), respectively. Corresponding values for the HA-VTE computable phenotype were 84.2% (95% CI, 60.8%-94.8%) and 72.3% (95% CI, 40.9%-90.8%). Conclusion: We developed computable phenotypes for HA-VTE and POA-VTE with adequate positive predictive value and sensitivity. This phenotype can be used in electronic health record data-based research.

引用

页数：8