Evidence mapPaperPMID 39158361Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2024

Development of electronic health record based algorithms to identify individuals with diabetic retinopathy.

Joseph H Breeyear, Sabrina L Mitchell, Cari L Nealon, Jacklyn N Hellwege, Brian Charest, Anjali Khakharia, Christopher W Halladay, Janine Yang, Gustavo A Garriga, Otis D Wilson and 16 more

Abstract readValidation Study
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2024. 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
field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors.

Joseph H BreeyearDivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, United States.ORCID 0000-0002-6179-0515
Sabrina L MitchellVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Cari L NealonEye Clinic, VA Northeast Ohio Healthcare System, Cleveland, OH 44106, United States.
Jacklyn N HellwegeVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Brian CharestMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA 02111, United States.
Anjali KhakhariaVA Atlanta Healthcare System, Decatur, GA 30033, United States.
Christopher W HalladayProvidence VA Medical Center, Providence, RI 02908, United States.
Janine YangDepartment of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, United States.
Gustavo A GarrigaDivision of Quantitative and Clinical Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Otis D WilsonVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Til B BasnetVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Adriana M HungVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Peter D ReavenPhoenix VA Health Care System, Phoenix, AZ 85012, United States.
James B MeigsProgram in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, United States.
Mary K RheeVA Atlanta Healthcare System, Decatur, GA 30033, United States.
Yang SunDepartment of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, United States.
Mary G LynchVA Atlanta Healthcare System, Decatur, GA 30033, United States.
Lucia SobrinDepartment of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, United States.
Milam A BrantleyVA Tennessee Valley Healthcare System (626), Nashville, TN 37212, United States.
Yan V SunVA Atlanta Healthcare System, Decatur, GA 30033, United States.ORCID 0000-0002-2838-1824
Peter W WilsonVA Atlanta Healthcare System, Decatur, GA 30033, United States.
Sudha K IyengarResearch Service, VA Northeast Ohio Healthcare System, Cleveland, OH 44106, United States.
Neal S PeacheyResearch Service, VA Northeast Ohio Healthcare System, Cleveland, OH 44106, United States.
Lawrence S PhillipsVA Atlanta Healthcare System, Decatur, GA 30033, United States.
Todd L EdwardsDivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
Ayush GiriDivision of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, United States.ORCID 0000-0002-7786-4670

Funding

Building Interdisciplinary Research Careers in Women's *K12HD043483 · VANDERBILT UNIVERSITY · 2002 to 2005
$1.9M
CRISPR Based Rescue of Glaucoma in Lowe SyndromeR01EY025295 · STANFORD UNIVERSITY · 2025 to 2025
$613k
BLRD VA I01 BX004557BLRD VA I01 BX005831BLRD VA IK6 BX005233CSRD VA I01 CX001481CSRD VA I01 CX001897NEI NIH HHS F31 EY033663NEI NIH HHS R01 EY025295NEI NIH HHS R01 EY032159NICHD NIH HHS K12 HD043483NIDDK NIH HHS K01 DK120631NIH HHS F31 EY033663Research to Prevent BlindnessVA Office of Research and Development I01 CX001298
6 · The paper itself

Abstract

objectivesTo develop, validate, and implement algorithms to identify diabetic retinopathy (DR) cases and controls from electronic health care records (EHRs). MATERIALS AND

methodsWe developed and validated electronic health record (EHR)-based algorithms to identify DR cases and individuals with type I or II diabetes without DR (controls) in 3 independent EHR systems: Vanderbilt University Medical Center Synthetic Derivative (VUMC), the VA Northeast Ohio Healthcare System (VANEOHS), and Massachusetts General Brigham (MGB). Cases were required to meet 1 of the following 3 criteria: (1) 2 or more dates with any DR ICD-9/10 code documented in the EHR, (2) at least one affirmative health-factor or EPIC code for DR along with an ICD9/10 code for DR on a different day, or (3) at least one ICD-9/10 code for any DR occurring within 24 hours of an ophthalmology examination. Criteria for controls included affirmative evidence for diabetes as well as an ophthalmology examination.

resultsThe algorithms, developed and evaluated in VUMC through manual chart review, resulted in a positive predictive value (PPV) of 0.93 for cases and negative predictive value (NPV) of 0.91 for controls. Implementation of algorithms yielded similar metrics in VANEOHS (PPV = 0.94; NPV = 0.86) and lower in MGB (PPV = 0.84; NPV = 0.76). In comparison, the algorithm for DR implemented in Phenome-wide association study (PheWAS) in VUMC yielded similar PPV (0.92) but substantially reduced NPV (0.48). Implementation of the algorithms to the Million Veteran Program identified over 62 000 DR cases with genetic data including 14 549 African Americans and 6209 Hispanics with DR. CONCLUSIONS/DISCUSSION: We demonstrate the robustness of the algorithms at 3 separate healthcare centers, with a minimum PPV of 0.84 and substantially improved NPV than existing automated methods. We strongly encourage independent validation and incorporation of features unique to each EHR to enhance algorithm performance for DR cases and controls.

Indexed as

AlgorithmsDiabetic RetinopathyElectronic Health RecordsAdultAgedCase-Control StudiesDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FemaleHumansInternational Classification of DiseasesMaleMiddle Agedalgorithm developmentalgorithm validationdiabetes complicationsdiabetic retinopathy

Identifiers

PMID39158361
PMCPMC11491608

What Socratic holds

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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.