Publication Date
5-1-2023
Journal
Research and Practice in Thrombosis and Haemostasis
DOI
10.1016/j.rpth.2023.100162
PMID
37342252
PMCID
PMC10277582
PubMedCentral® Posted Date
4-24-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
electronic health records, inpatients, International Classification of Diseases, predictive value of tests, venous thromboembolism
Abstract
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 computable 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.
Included in
Health and Medical Administration Commons, Health Information Technology Commons, Hematology Commons, Hemic and Lymphatic Diseases Commons, Medical Sciences Commons, Neoplasms Commons, Oncology Commons
Comments
Associated Data