Improved Identification of Venous Thromboembolism From Electronic Medical Records Using a Novel Information Extraction Software Platform
Improved Identification of Venous Thromboembolism From Electronic Medical Records Using a Novel Information Extraction Software Platform
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DOI：
10.1097/mlr.0000000000000831
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发表时间：
2018-09-01
期刊：
影响因子：
3
通讯作者：
Wang, Fusheng
中科院分区：
文献类型：
--
作者：
Dantes, Raymund B.;Zheng, Shuai;Wang, Fusheng
简介：美国联邦政府规定的静脉血栓栓塞（VTE）报告，由医疗保健研究和质量机构患者安全指标12（AHRQ PSI-12）定义，基于管理数据，其准确性尚未得到一致证明。我们使用IDEAL-X，一种新的信息提取软件系统，从电子病历中识别VTE，并评估其准确性。方法：回顾了2009年至2014年在骨科专科医院住院的13，248例患者的病历。患者就诊定义为住院，其中进行了手术（脊柱、髋关节或膝关节）和可检测VTE的放射学诊断研究。结果：在2083份放射学报告中，IDEAL-X正确识别了176/181起VTE事件，与手动审查相比，灵敏度为97.2% [95%置信区间（CI），93.7%-99.1%]，特异性为99.3%（95%CI，98.9%-99.7%）。在422例VTE诊断性放射学研究的手术中，IDEAL-X正确识别了42例VTE事件中的41例，灵敏度为97.6%（95% CI，87.4%-99.6%），特异性为99.8%（95% CI，98.7%-100.0%）。其敏感性为92.9%（95%CI，80.5%-98.4%），特异性为92.9%（95%CI，89.8%-95.3%），但仅特异性差异有统计学意义（P
Introduction:The United States federally mandated reporting of venous thromboembolism (VTE), defined by Agency for Healthcare Research & Quality Patient Safety Indicator 12 (AHRQ PSI-12), is based on administrative data, the accuracy of which has not been consistently demonstrated. We used IDEAL-X, a novel information extraction software system, to identify VTE from electronic medical records and evaluated its accuracy.Methods:Medical records for 13,248 patients admitted to an orthopedic specialty hospital from 2009 to 2014 were reviewed. Patient encounters were defined as a hospital admission where both surgery (of the spine, hip, or knee) and a radiology diagnostic study that could detect VTE was performed. Radiology reports were both manually reviewed by a physician and analyzed by IDEAL-X.Results:Among 2083 radiology reports, IDEAL-X correctly identified 176/181 VTE events, achieving a sensitivity of 97.2% [95% confidence interval (CI), 93.7%-99.1%] and specificity of 99.3% (95% CI, 98.9%-99.7%) when compared with manual review. Among 422 surgical encounters with diagnostic radiographic studies for VTE, IDEAL-X correctly identified 41 of 42 VTE events, achieving a sensitivity of 97.6% (95% CI, 87.4%-99.6%) and specificity of 99.8% (95% CI, 98.7%-100.0%). The performance surpassed that of AHRQ PSI-12, which had a sensitivity of 92.9% (95% CI, 80.5%-98.4%) and specificity of 92.9% (95% CI, 89.8%-95.3%), though only the difference in specificity was statistically significant (P