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Validation of Pediatric Diabetes Case Identification Approaches for Diagnosed Cases by Using Information in the Electronic Health Records of a Large Integrated Managed Health Care Organization.
- Source :
-
American Journal of Epidemiology . Jan2014, Vol. 179 Issue 1, p27-38. 12p. - Publication Year :
- 2014
-
Abstract
- We explored the utility of different algorithms for diabetes case identification by using electronic health records. Inpatient and outpatient diagnosis codes, as well as data on laboratory results and dispensing of antidiabetic medications were extracted from electronic health records of Kaiser Permanente Southern California members who were less than 20 years of age in 2009. Diabetes cases were ascertained by using the SEARCH for Diabetes in Youth Study protocol and comprised the “gold standard.” Sensitivity, specificity, positive and negative predictive values, accuracy, and the area under the receiver operating characteristic curve (AUC) were compared in 1,000 bootstrapped samples. Based on data from 792,992 youth, of whom 1,568 had diabetes (77.2%, type 1 diabetes; 22.2%, type 2 diabetes; 0.6%, other), case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions (sensitivity, 95.9%; positive predictive value, 95.5%; AUC, 97.9%) and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications (sensitivity, 92.4%; positive predictive value, 98.4%; AUC, 96.2%). Having 1 or more outpatient type 1 diabetes diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification, code 250.x1 or 250.x3) had the highest accuracy (94.4%) and AUC (94.1%) for type 1 diabetes; the absence of type 1 diabetes diagnosis had the highest accuracy (93.8%) and AUC (93.6%) for identifying type 2 diabetes. Information in the electronic health records from managed health care organizations provides an efficient and cost-effective source of data for childhood diabetes surveillance. [ABSTRACT FROM PUBLISHER]
- Subjects :
- *DIAGNOSIS of diabetes
*TYPE 2 diabetes diagnosis
*HYPOGLYCEMIC agents
*PUBLIC health surveillance
*TYPE 1 diabetes
*MANAGED care plan statistics
*MANAGED care programs
*ALGORITHMS
*CLINICAL medicine
*CONFIDENCE intervals
*IDENTIFICATION
*PATIENTS
*RESEARCH
*RESEARCH funding
*KEY performance indicators (Management)
*PREDICTIVE validity
*RETROSPECTIVE studies
*RECEIVER operating characteristic curves
*ELECTRONIC health records
*DESCRIPTIVE statistics
*CHILDREN
*DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 00029262
- Volume :
- 179
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- American Journal of Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 93065473
- Full Text :
- https://doi.org/10.1093/aje/kwt230