An Electronic Search Algorithm for Early Disseminated Intravascular Coagulopathy Diagnosis in the Intensive Care Unit: A Derivation and Validation Study

Curēus
Tabinda JawaidRahul Kashyap

Abstract

We aim to create and validate an electronic search algorithm for accurate detection of disseminated intravascular coagulopathy (DIC) from medical records. Patients with DIC in Mayo Clinic's intensive care units (ICUs) from Jan 1, 2007, to May 4, 2018, were included in the study. An algorithm was developed based on clinical notes and ICD diagnosis codes. A cohort of 50 patients was included with DIC diagnosis, its variations, and no diagnosis of DIC. Then, the next set of 50 patients was used to refine the algorithm. Results were compared with a manual reviewer and the disagreements were resolved by the third reviewer. The same process was repeated with 'revised clinical note search' for the first and second derivation cohort with additional exclusion terms. The obtained sensitivity and specificity were reported. The generated algorithm was applied to another set of 50 patients for validation. In the first derivation cohort- DIC search by clinical notes and diagnosis codes had 92% sensitivity and 100% specificity. Sensitivity dropped to 71% in the second cohort although specificity remains the same. Therefore, the algorithm was refined to clinical notes search only. The revised search was reapplied to first and second derivation...Continue Reading

References

Feb 6, 2013·Journal of Thrombosis and Haemostasis : JTH·H WadaUNKNOWN The Scientific Standardization Committee on DIC of the International Society on Thrombosis Haemostasis
Dec 10, 2013·Hematology·Cheng Hock Toh, Yasir Alhamdi
Feb 28, 2014·The New England Journal of Medicine·Beverley J Hunt
Mar 17, 2015·Neurosurgery Clinics of North America·Jonathan T Carter
Oct 8, 2015·Obstetrics and Gynecology·F Gary Cunningham, David B Nelson
Mar 25, 2016·Journal of Intensive Care·Kohji OkamotoYusuke Sawatsubashi
Nov 25, 2018·Journal of Critical Care·Shinjiro SaitoUNKNOWN Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group
May 10, 2020·BMC Medical Informatics and Decision Making·Rahul KashyapKianoush B Kashani

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Software Mentioned

DataMart
Advanced Cohort Explorer ( ACE )
Advanced Explorer
Advanced Explorer Platform
JMP
ACE
Advanced Cohort Explorer
ICU DataMart

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