Evidence map›Paper›PMID 24637142›Full record

ArticleJournal of biomedical informatics2014

Development of reusable logic for determination of statin exposure-time from electronic health records.

Aaron W Miller, Catherine A McCarty, Ulrich Broeckel, Vangelis Hytopoulos, Deanna S Cross

Open access · greenAbstract readValidation Study
In one paragraph

Article in Journal of biomedical informatics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Effect of Statin Use on Influenza Vaccine Effectiveness.The Journal of infectious diseases · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Aaron W MillerBiomedical Informatics Research Center, Marshfield Clinic Research Foundation, 1000 North Oak Avenue, Marshfield, WI 54449, USA. Electronic address: miller.aaron@mcrf.mfldclin.edu.
Catherine A McCartyEssentia Institute of Rural Health, 502 East Second Street, Duluth, MN 55805, USA.
Ulrich BroeckelDepartment of Pediatrics, Medical College of Wisconsin, TBCR-CRI, Room C2440, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
Vangelis HytopoulosAviir Corp, Department of Computational Sciences, 9805 Research Drive, Irvine, CA 92618, USA.
Deanna S CrossDepartment of Forensic and Investigative Genetics, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA.
Essentia Health · USMarshfield Clinic · USMedical College of Wisconsin · USUniversity of North Texas · US

Funding

Institutional Clinical and Translational Science AwardUL1TR000427 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI DREZNER, MARC KENNETH · 2012 to 2016
$32.2M
Institutional Clinical and Translational Science AwardKL2TR000428 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI DREZNER, MARC KENNETH · 2012 to 2016
$6.2M
Genome Wide Association of Coronary Artery Disease and Related Risk FactorsR01HL089655 · NHLBI · MEDICAL COLLEGE OF WISCONSIN · PI BROECKEL, ULRICH · 2008 to 2012
$3.8M
Genome-Wide Study of Cataract and Low HDL in the Personalized Medicine Research PU01HG004608 · NHGRI · MARSHFIELD CLINIC RESEARCH FOUNDATION · PI MCCARTY, CATHERINE ANNE · 2007 to 2010
$3.3M
NCATS NIH HHS KL2 TR000428NCATS NIH HHS UL1 TR000427NCATS NIH HHS UL1TR000427NHGRI NIH HHS 1U01HG004608NHGRI NIH HHS U01 HG004608NHLBI NIH HHS 5R01HL089655NHLBI NIH HHS R01 HL089655
6 · The paper itself

Abstract

objectiveWe aim to quantify HMG-CoA reductase inhibitor (statin) prescriber-intended exposure-time using a generalizable algorithm that interrogates data stored in the electronic health record (EHR). MATERIALS AND

methodsThis study was conducted using the Marshfield Clinic (MC) Personalized Medicine Research Project (PMRP) a central Wisconsin-based population and biobank with, on average, 30 years of electronic health data available in the independently-developed MC Cattails MD EHR. Individuals with evidence of statin exposure were identified from the electronic records, and manual chart abstraction of all mentions of prescribed statins was completed. We then performed electronic chart abstraction of prescriber-intended exposure time for statins, using previously identified logic to capture pill-splitting events, normalizing dosages to atorvastatin-equivalent dose. Four models using iterative training sets were tested to capture statin end-dates. Calculated cumulative provider-intended exposures were compared to manually abstracted gold-standard measures of ordered statin prescriptions, and aggregate model results (totals) for training and validation populations were compared. The most successful model was the one with the smallest discordance between modeled and manually abstracted Atorvastatin 10mg/year Equivalents (AEs).

resultsOf the approximately 20,000 patients enrolled in the PMRP, 6243 were identified with statin exposure during the study period (1997-2011), 59.8% of whom had been prescribed multiple statins over an average of approximately 11 years. When the best-fit algorithm was implemented and validated by manual chart review for the statin-ordered population, it was found to capture 95.9% of the correlation between calculated and expected statin provider-intended exposure time for a random validation set, and the best-fit model was able to predict intended statin exposure to within a standard deviation of 2.6 AEs, with a standard error of +0.23 AEs.

conclusionWe demonstrate that normalized provider-intended statin exposure time can be estimated using a combination of structured clinical data sources, including a medications ordering system and a clinical appointment coordination system, supplemented with text data from clinical notes.

Indexed as

Electronic Health RecordsAlgorithmsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsModels, TheoreticalHydroxymethylglutaryl-CoA Reductase InhibitorsAlgorithmAnticholesteremic agentsDrug dosage calculationsElectronic health recordsHMG-CoAStatins

Identifiers

PMID24637142
PMCPMC4327888
OpenAlexW1991319413

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.