Electronic health record phenotyping improves detection and screening of type 2 diabetes in the general United States population: A cross-sectional, unselected, retrospective study

Journal of Biomedical Informatics
Ariana E AndersonMark S Cohen

Abstract

An estimated 25% of type two diabetes mellitus (DM2) patients in the United States are undiagnosed due to inadequate screening, because it is prohibitive to administer laboratory tests to everyone. We assess whether electronic health record (EHR) phenotyping could improve DM2 screening compared to conventional models, even when records are incomplete and not recorded systematically across patients and practice locations, as is typically seen in practice. In this cross-sectional, retrospective study, EHR data from 9948 US patients were used to develop a pre-screening tool to predict current DM2, using multivariate logistic regression and a random-forests probabilistic model for out-of-sample validation. We compared (1) a full EHR model containing commonly prescribed medications, diagnoses (as ICD9 categories), and conventional predictors, (2) a restricted EHR DX model which excluded medications, and (3) a conventional model containing basic predictors and their interactions (BMI, age, sex, smoking status, hypertension). Using a patient's full EHR or restricted EHR was superior to using basic covariates alone for detecting individuals with diabetes (hierarchical X(2) test, p<0.001). Migraines, depot medroxyprogesterone acetate, a...Continue Reading

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Citations

Sep 28, 2016·Journal of Biomedical Informatics·Samah Fodeh, Qing Zeng
Dec 10, 2016·Journal of Diabetes Science and Technology·Rina KagawaKazuhiko Ohe
Mar 2, 2018·Journal of Diabetes Science and Technology·Arianna DagliatiLucia Sacchi
Sep 4, 2018·Alzheimer's & Dementia : Translational Research & Clinical Interventions·Justin B MillerGustavo Jimenez-Maggoria
Nov 29, 2019·Healthcare Informatics Research·Shahabeddin AbhariAli Garavand
Oct 13, 2017·Journal of the American Medical Informatics Association : JAMIA·Anando SenChunhua Weng
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Dec 15, 2020·Journal of the American Medical Informatics Association : JAMIA·Hossein EstiriShawn N Murphy
Sep 9, 2019·Emily SorianoRahmatollah Beheshti
Mar 20, 2020·Joyce C. HoYubin Park
Feb 21, 2018·Tony SahamaHamzah Osop

Related Concepts

Machine Learning
Prevalence Studies
Diabetes Mellitus, Non-Insulin-Dependent
Health Information Technology
Retrospective Studies
Receiver Operating Characteristic
Two-Parameter Models
Logistic Regression
Area Under Curve
Electronic Health Records

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