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Kuang A, Xu C, Southern DA, Sandhu N, Quan H. Validated administrative data based ICD-10 algorithms for chronic conditions: A systematic review. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202744. [PMID: 38971056 DOI: 10.1016/j.jeph.2024.202744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE This systematic review aimed to identify ICD-10 based validated algorithms for chronic conditions using health administrative data. METHODS A comprehensive systematic literature search using Ovid MEDLINE, Embase, PsycINFO, Web of Science and CINAHL was performed to identify studies, published between 1983 and May 2023, on validated algorithms for chronic conditions using administrative health data. Two reviewers independently screened titles and abstracts and reviewed full text of selected studies to complete data extraction. A third reviewer resolved conflicts arising at the screening or study selection stages. The primary outcome was validated studies of ICD-10 based algorithms with both sensitivity and PPV of ≥70 %. Studies with either sensitivity or PPV <70 % were included as secondary outcomes. RESULTS Overall, the search identified 1686 studies of which 54 met the inclusion criteria. Combining a previously published literature search, a total of 61 studies were included for data extraction. The study identified 40 chronic conditions with high validity and 22 conditions with moderate validity. The validated algorithms were based on administrative data from different countries including Canada, USA, Australia, Japan, France, South Korea, and Taiwan. The algorithms identified included several types of cancers, cardiovascular conditions, kidney diseases, gastrointestinal disorders, and peripheral vascular diseases, amongst others. CONCLUSION With ICD-10 prominently used across the world, this up-to-date systematic review can prove to be a helpful resource for research and surveillance initiatives using administrative health data for identifying chronic conditions.
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Affiliation(s)
- Angela Kuang
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Claire Xu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Danielle A Southern
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Namneet Sandhu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Hude Quan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Calderón-Parra J, Gutiérrez-Villanueva A, Yagüe-Diego I, Cobo M, Domínguez F, Forteza A, Ana FC, Muñez-Rubio E, Moreno-Torres V, Ramos-Martínez A. Trends in epidemiology, surgical management, and prognosis of infective endocarditis during the XXI century in Spain: A population-based nationwide study. J Infect Public Health 2024; 17:881-888. [PMID: 38555656 DOI: 10.1016/j.jiph.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/08/2024] [Accepted: 03/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Few population-based studies have evaluated the epidemiology of infective endocarditis (IE). Changes in population demographics and guidelines on IE may have affected both the incidence and outcomes of IE. Therefore, the aim of our study is to provide contemporary population-based epidemiological data of IE in Spain. METHODS Retrospective nationwide observational study using data from the Spanish National Health System Discharge Database. We included all patients hospitalized with IE from January 2000 to December 2019. RESULTS A total of 64,550 IE episodes were included. The incidence of IE rose from 5.25 cases/100,000 person-year in 2000 to 7.21 in 2019, with a 2% annual percentage change (95% CI 1.3-2.6). IE incidence was higher among those aged 85 or older (43.5 cases/100.000 person-years). Trends across the study period varied with sex and age. Patients with IE were progressively older (63.9 years in 2000-2004 to 70.0 in 2015-2019, p < 0.001) and had more frequent comorbidities and predispositions, including, previous valvular prosthesis (12.1% vs 20.9%, p < 0.001). After adjustment, a progressive reduction in mortality was noted including in 2015-2019 compared to 2010-2014 (adjusted odds ratio 0.93, 95% confident interval 0.88-0.99, p = 0.023)., which was associated with more frequent cardiac surgery in recent years (15.1% in 2010-2014 vs 19.9% in 2015-2019). CONCLUSIONS In Spain, the incidence of IE has increased during the XXI century, with a more pronounced increase in elderly individuals. Adjusted-mortality decreased over the years, which could be related to a higher percentage of surgery. Our results highlight the changing epidemiology of IE.
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Affiliation(s)
- Jorge Calderón-Parra
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain.
| | - Andrea Gutiérrez-Villanueva
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain
| | - Itziar Yagüe-Diego
- Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain
| | - Marta Cobo
- Department of Cardiology, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain
| | - Fernando Domínguez
- Department of Cardiology, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain
| | - Alberto Forteza
- Department of Cardiac Surgery, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain
| | - Fernández-Cruz Ana
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain; Autónoma University of Madrid, Spain
| | - Elena Muñez-Rubio
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain
| | - Victor Moreno-Torres
- Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain; Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; UNIR Health Sciences School, Madrid, Spain
| | - Antonio Ramos-Martínez
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital Puerta de Hierro, Majadahonda, Majadahonda, Spain; Research Institute Puerta de Hierro-Segovia de Arana (IDIPHSA). Majadahonda, Spain; Autónoma University of Madrid, Spain
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Pokorney SD, Zepel L, Greiner MA, Fowler VG, Black-Maier E, Lewis RK, Hegland DD, Granger CB, Epstein LM, Carrillo RG, Wilkoff BL, Hardy C, Piccini JP. Lead Extraction and Mortality Among Patients With Cardiac Implanted Electronic Device Infection. JAMA Cardiol 2023; 8:1165-1173. [PMID: 37851461 PMCID: PMC10585491 DOI: 10.1001/jamacardio.2023.3379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/05/2023] [Indexed: 10/19/2023]
Abstract
Importance Complete hardware removal is a class I recommendation for cardiovascular implantable electronic device (CIED) infection, but practice patterns and outcomes remain unknown. Objective To quantify the number of Medicare patients with CIED infections who underwent implantation from 2006 to 2019 and lead extraction from 2007 to 2019 to analyze the outcomes in these patients in a nationwide clinical practice cohort. Design, Setting, and Participants This cohort study included fee-for-service Medicare Part D beneficiaries from January 1, 2006, to December 31, 2019, who had a de novo CIED implantation and a CIED infection more than 1 year after implantation. Data were analyzed from January 1, 2005, to December 31, 2019. Exposure A CIED infection, defined as (1) endocarditis or infection of a device implant and (2) documented antibiotic therapy. Main Outcomes and Measures The primary outcomes of interest were device infection, device extraction, and all-cause mortality. Time-varying multivariable Cox proportional hazards regression models were used to evaluate the association between extraction and survival. Results Among 1 065 549 patients (median age, 78.0 years [IQR, 72.0-84.0 years]; 50.9% male), mean (SD) follow-up was 4.6 (2.9) years after implantation. There were 11 304 patients (1.1%) with CIED infection (median age, 75.0 years [IQR, 67.0-82.0 years]); 60.1% were male, and 7724 (68.3%) had diabetes. A total of 2102 patients with CIED infection (18.6%) underwent extraction within 30 days of diagnosis. Infection occurred a mean (SD) of 3.7 (2.4) years after implantation, and 1-year survival was 68.3%. There was evidence of highly selective treatment, as most patients did not have extraction within 30 days of diagnosed infection (9202 [81.4%]), while 1511 (13.4%) had extraction within 6 days of diagnosis and 591 (5.2%) had extraction between days 7 and 30. Any extraction was associated with lower mortality compared with no extraction (adjusted hazard ratio [AHR], 0.82; 95% CI, 0.74-0.90; P < .001). Extraction within 6 days was associated with even lower risk of mortality (AHR, 0.69; 95% CI, 0.61-0.78; P < .001). Conclusions and Relevance In this study, a minority of patients with CIED infection underwent extraction. Extraction was associated with a lower risk of death compared with no extraction. The findings suggest a need to improve adherence to guideline-directed care among patients with CIED infection.
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Affiliation(s)
- Sean D. Pokorney
- Duke University Medical Center, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | - Lindsay Zepel
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Melissa A. Greiner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Vance G. Fowler
- Duke University Medical Center, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | | | | | | | - Christopher B. Granger
- Duke University Medical Center, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | | | | | | | - Chantelle Hardy
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Jonathan P. Piccini
- Duke University Medical Center, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
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Docheva N, Heimberger S, Mueller A, Bisson C, Arenas G, Perdigao JL, Kordik A, Stewart K, Goodall P, Lengyel E, Rana S. A Comparison of Obstetric Interventions and Outcomes Between Black and White Patients at an Urban Tertiary Medical Center. Reprod Sci 2023; 30:2313-2323. [PMID: 36717463 DOI: 10.1007/s43032-023-01174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/13/2023] [Indexed: 02/01/2023]
Abstract
The objective of the study is to evaluate whether rates of selected labor and delivery interventions and severe maternal morbidity (SMM) differ between Black and White pregnant patients. This retrospective observational cohort study included all Black or White pregnant patients who delivered at the University of Chicago Medical Center between January 2015 and December 2019. Data queried included demographic information, antepartum complications, preterm interventions, labor and delivery events, and neonatal outcomes. SMM was a composite outcome, including intensive care unit admission, blood transfusion, hysterectomy, eclampsia, cardiac arrest, or death. In total, 10,885 parturients (9001 Black and 1884 White) and 11,211 neonates (9254 born to Black and 1957 to White patients) were included in the study. Black patients were more likely to have preterm labor (3.51% vs. 1.86%, p = 0.0002) and no prenatal care (17.83% vs. 4.05%, p < 0.0001). There was no significant difference in the administration of magnesium sulfate for fetal neuroprotection (Black 44.78% vs. White 49.32%, p = 0.48) or antenatal corticosteroids (Black 67.83% vs. White 71.98%, p = 0.28) among those with preterm delivery. There was no significant difference in SMM (Black 2.24% vs. White 2.44%, p = 0.60), and SMM rates decreased over time (OR 0.79 per year, 95% CI: 0.72-0.87, p < 0.0001) for all patients. Black patients had more pregnancy complications, but their complications were addressed with similar rates of obstetrical interventions. In a high-resource setting, there was no difference in rates of SMM when compared to White patients.
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Affiliation(s)
- Nikolina Docheva
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Sarah Heimberger
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Ariel Mueller
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Courtney Bisson
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Gabriel Arenas
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Joana Lopes Perdigao
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Abbe Kordik
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Karie Stewart
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Perpetua Goodall
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA
| | - Sarosh Rana
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2050, Chicago, IL, 60637, USA.
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Anetta K, Horak A, Wojakowski W, Wita K, Jadczyk T. Deep Learning Analysis of Polish Electronic Health Records for Diagnosis Prediction in Patients with Cardiovascular Diseases. J Pers Med 2022; 12:jpm12060869. [PMID: 35743653 PMCID: PMC9225281 DOI: 10.3390/jpm12060869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 02/05/2023] Open
Abstract
Electronic health records naturally contain most of the medical information in the form of doctor’s notes as unstructured or semi-structured texts. Current deep learning text analysis approaches allow researchers to reveal the inner semantics of text information and even identify hidden consequences that can offer extra decision support to doctors. In the presented article, we offer a new automated analysis of Polish summary texts of patient hospitalizations. The presented models were found to be able to predict the final diagnosis with almost 70% accuracy based just on the patient’s medical history (only 132 words on average), with possible accuracy increases when adding further sentences from hospitalization results; even one sentence was found to improve the results by 4%, and the best accuracy of 78% was achieved with five extra sentences. In addition to detailed descriptions of the data and methodology, we present an evaluation of the analysis using more than 50,000 Polish cardiology patient texts and dive into a detailed error analysis of the approach. The results indicate that the deep analysis of just the medical history summary can suggest the direction of diagnosis with a high probability that can be further increased just by supplementing the records with further examination results.
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Affiliation(s)
- Kristof Anetta
- Natural Language Processing Centre, Faculty of Informatics, Masaryk University, 602 00 Brno, Czech Republic;
| | - Ales Horak
- Natural Language Processing Centre, Faculty of Informatics, Masaryk University, 602 00 Brno, Czech Republic;
- Correspondence: (A.H.); (T.J.)
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Krystian Wita
- First Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
- Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
- Correspondence: (A.H.); (T.J.)
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Corcorran MA, Stewart J, Lan K, Gupta A, Glick SN, Seshadri C, Koomalsingh KJ, Gibbons EF, Harrington RD, Dhanireddy S, Kim HN. Correlates of 90-day Mortality Among People Who Do and Do Not Inject Drugs with Infective Endocarditis in Seattle, Washington. Open Forum Infect Dis 2022; 9:ofac150. [PMID: 35493129 PMCID: PMC9045945 DOI: 10.1093/ofid/ofac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Infective endocarditis (IE) remains highly morbid, but few studies have evaluated factors associated with IE mortality. We examined correlates of 90-day mortality among people who inject drugs (PWID) and people who do not inject drugs (non-PWID). Methods We queried the electronic medical record for cases of IE among adults ≥18 years of age at 2 academic medical centers in Seattle, Washington, from 1 January 2014 to 31 July 2019. Cases were reviewed to confirm a diagnosis of IE and drug use status. Deaths were confirmed through the Washington State death index. Descriptive statistics were used to characterize IE in PWID and non-PWID. Kaplan-Meier log-rank tests and Cox proportional hazard models were used to assess correlates of 90-day mortality. Results We identified 507 patients with IE, 213 (42%) of whom were PWID. Sixteen percent of patients died within 90 days of admission, including 14% of PWID and 17% of non-PWID (P = .50). In a multivariable Cox proportional hazard model, injection drug use was associated with a higher mortality within the first 14 days of admission (adjusted hazard ratio [aHR], 2.33 [95% confidence interval {CI}, 1.16–4.65], P = .02); however, there was no association between injection drug use and mortality between 15 and 90 days of admission (aHR, 0.63 [95% CI, .31–1.30], P = .21). Conclusions Overall 90-day mortality did not differ between PWID and non-PWID with IE, although PWID experienced a higher risk of death within 14 days of admission. These findings suggest that early IE diagnosis and treatment among PWID is critical to improving outcomes.
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Affiliation(s)
| | - Jenell Stewart
- Department of Medicine University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Kristine Lan
- Department of Medicine University of Washington, Seattle, WA, USA
| | - Ayushi Gupta
- Department of Medicine University of Washington, Seattle, WA, USA
| | - Sara N Glick
- Department of Medicine University of Washington, Seattle, WA, USA
- HIV/STD Program, Public Health – Seattle & King County, Seattle, WA, USA
| | - Chetan Seshadri
- Department of Medicine University of Washington, Seattle, WA, USA
| | | | - Edward F Gibbons
- Department of Medicine University of Washington, Seattle, WA, USA
| | | | | | - H Nina Kim
- Department of Medicine University of Washington, Seattle, WA, USA
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Diagnostic accuracy of ICD code versus discharge summary-based query for endocarditis cohort identification: Erratum. Medicine (Baltimore) 2022; 101:e28713. [PMID: 35089236 PMCID: PMC8797604 DOI: 10.1097/md.0000000000028713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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