Electronic Triggers to Identify Delays in Follow-Up of Mammography: Harnessing the Power of Big Data in Health Care

Journal of the American College of Radiology : JACR
Daniel R MurphyHardeep Singh

Abstract

We previously developed electronic triggers to automatically flag records for patients experiencing potential delays in diagnostic evaluation for certain cancers. Because of the unique clinical, logistic, and legal aspects of mammography, this study was conducted to evaluate the effectiveness of a trigger to flag delayed follow-up on mammography. An algorithm was developed to detect delays in follow-up of abnormal mammographic results (>60 days for BI-RADS® 0, 4, and 5 and >7 months for BI-RADS 3) using clinical data in the electronic health record. Flagged records were then manually reviewed to determine the trigger's performance characteristics (positive and negative predictive value, sensitivity, and specificity). The frequency of delays and patient communication related to abnormal results, reasons for lack of follow-up, and whether patients were subsequently diagnosed with breast cancer were also assessed. Of 365,686 patients seen between January 1, 2010, and May 31, 2015, the trigger identified 2,129 patients with abnormal findings on mammography, of whom it flagged 552 as having delays in follow-up. From these, review of 400 randomly selected records revealed 283 true delays (positive predictive value, 71%; 95% confidenc...Continue Reading

Citations

Dec 13, 2018·Health Informatics Journal·Dean F SittigHardeep Singh
Oct 7, 2018·BMJ Quality & Safety·Daniel R MurphyHardeep Singh
Apr 29, 2021·Journal of General Internal Medicine·Andrew J ZimolzakHardeep Singh
Jul 22, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Debra T ChoiYvonne Hsiao-Fan Sada
Jul 20, 2021·Journal of the American Medical Informatics Association : JAMIA·Viralkumar VaghaniHardeep Singh

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