1. A Digital Case-Finding Algorithm for Diagnosed but Untreated Hepatitis C: A Tool for Increasing Linkage to Treatment and Cure
- Author
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Amreen Dinani, Brooke Wyatt, Mark W. Miller, Ning Ma, Maxence Vandromme, Li Li, Andrea D. Branch, Francina Collado, Chip A. Bowman, Jihae Jeon, Lismeiry Paulino, Ponni V. Perumalswami, Douglas T. Dieterich, Alyson Harty, and Anna Mageras
- Subjects
Linkage (software) ,Male ,Hepatology ,business.industry ,Medical record ,Information Storage and Retrieval ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,medicine.disease ,Logistic regression ,Antiviral Agents ,Hcv elimination ,Virological response ,Positive predicative value ,Medicine ,Case finding ,Electronic Health Records ,Feasibility Studies ,Humans ,Female ,business ,Algorithm ,Algorithms ,Aged - Abstract
BACKGROUND AND AIMS Although chronic HCV infection increases mortality, thousands of patients remain diagnosed-but-untreated (DBU). We aimed to (1) develop a DBU phenotyping algorithm, (2) use it to facilitate case finding and linkage to care, and (3) identify barriers to successful treatment. APPROACH AND RESULTS We developed a phenotyping algorithm using Java and SQL and applied it to ~2.5 million EPIC electronic medical records (EMRs; data entered January 2003 to December 2017). Approximately 72,000 EMRs contained an HCV International Classification of Diseases code and/or diagnostic test. The algorithm classified 10,614 cases as DBU (HCV-RNA positive and alive). Its positive and negative predictive values were 88% and 97%, respectively, as determined by manual review of 500 EMRs randomly selected from the ~72,000. Navigators reviewed the charts of 6,187 algorithm-defined DBUs and they attempted to contact potential treatment candidates by phone. By June 2020, 30% (n = 1,862) had completed an HCV-related appointment. Outcomes analysis revealed that DBU patients enrolled in our care coordination program were more likely to complete treatment (72% [n = 219] vs. 54% [n = 256]; P
- Published
- 2021