Validation of the Use of Electronic Health Records for Classification of ADHD Status.

Validation of the Use of Electronic Health Records for Classification of ADHD Status.
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DOI:
10.1177/1087054716672337
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发表时间:
2019-11-01
影响因子:
3
通讯作者:
Curry AE
Curry AE
中科院分区:
医学2区
文献类型:
--
作者:
Gruschow SM;Yerys BE;Power TJ;Durbin DR;Curry AE

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验证一种基于电子健康记录(EHR)的算法,以分类儿科患者的ADHD状态。作为应用研究的一部分,我们确定了费城儿童医院医疗保健网络的所有初级保健患者,他们出生于1987-1995年,居住在新泽西。如果患者的EHR在临床访视时或在已知条件列表中显示ICD-9-CM诊断代码为“314.x”,则将其归类为ADHD。我们手动审查了ADHD患者(n= 2,030)和非ADHD患者的随机加权样本(n= 13,579中的807)的EHR,以确认是否存在ADHD。根据不确定病例的假设,灵敏度范围为0.96-0.97(95% CI:0.95,0.97),特异性范围为0.98-0.99(0.97,0.99),阳性预测值范围为0.83-0.98(0.81,0.99)。基于EHR的诊断代码可以准确地对儿童患者的ADHD状态进行分类,并且可以用于大规模的流行病学和临床研究,具有高灵敏度和特异性。
To validate an electronic health record (EHR)-based algorithm to classify ADHD status of pediatric patients. As part of an applied study, we identified all primary care patients of The Children's Hospital of Philadelphia healthcare network who were born 1987–1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an ICD-9-CM diagnosis code of ‘314.x’ at a clinical visit or on a list of known conditions. We manually reviewed EHRs for ADHD patients (n=2,030) and a random weighted sample of non-ADHD patients (n=807 of 13,579) to confirm the presence or absence of ADHD. Depending on assumptions for inconclusive cases, sensitivity ranged from 0.96–0.97 (95% CI: 0.95, 0.97), specificity from 0.98–0.99 (0.97, 0.99), and positive predictive value from 0.83–0.98 (0.81, 0.99). EHR-based diagnostic codes can accurately classify ADHD status among pediatric patients and can be employed by large-scale epidemiologic and clinical studies with high sensitivity and specificity.
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