Identification of Nonresponse to Treatment Using Narrative Data in an Electronic Health Record Inflammatory Bowel Disease Cohort

Inflammatory Bowel Diseases
Ashwin N AnanthakrishnanIsaac Kohane

Abstract

Electronic health records, increasingly a part of healthcare, provide a wealth of untapped narrative free text data that have the potential to accurately inform clinical outcomes. From a validated cohort of patients with Crohn's disease or ulcerative colitis, we identified patients with ≥1 coded or narrative mention of monoclonal antibodies to tumor necrosis factor α. Chart review by ascertained true use of therapy, time of initiation, and cessation of treatment, and also clinical response stratified as nonresponse, partial, or complete response at 1 year. Internal consistency was assessed in an independent validation cohort. A total of 3087 patients had a mention of an antibodies to tumor necrosis factor α. Actual therapy initiation was within 60 days of the first coded mention in 74% of patients. In the derivation cohort, 18% of antibodies to tumor necrosis factor α starts were classified as nonresponse at 1 year, 21% as partial, and 56% as complete response. On multivariate analysis, the number of narrative mentions of diarrhea (odds ratio 1.08; 95% confidence interval, 1.02-1.14) and fatigue (odds ratio 1.16; 95% confidence interval, 1.02-1.32) was independently associated with nonresponse at 1 year (area under the curve 0....Continue Reading

References

Sep 19, 2008·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jennifer JonesWilliam J Sandborn
Mar 18, 2010·Arthritis Care & Research·Katherine P LiaoRobert M Plenge
Apr 7, 2010·American Journal of Human Genetics·Marylyn D RitchieDan M Roden
Aug 28, 2010·Health Affairs·Ashish K JhaMaulik S Joshi
Sep 8, 2010·Journal of the American Medical Informatics Association : JAMIA·Guergana K SavovaChristopher G Chute
Apr 22, 2011·Science Translational Medicine·Abel N KhoJoshua C Denny
May 19, 2011·Nature Reviews. Genetics·Isaac S Kohane
Jun 28, 2011·American Journal of Human Genetics·Iftikhar J KulloChristopher G Chute
Mar 1, 2012·Journal of the American Medical Informatics Association : JAMIA·Robert J CarrollJoshua C Denny
May 1, 2012·International Journal of Medical Informatics·Stephanie E PollardDavid W Bates
May 12, 2012·Applied Clinical Informatics·Peter D StetsonEugenia L Siegler
Jun 15, 2012·The New England Journal of Medicine·Kenneth D Mandl, Isaac S Kohane
Aug 24, 2012·Lancet·Daniel C Baumgart, William J Sandborn
Aug 24, 2012·Lancet·Ingrid OrdásWilliam J Sandborn
Mar 22, 2013·European Journal of Internal Medicine·Baptiste QuélennecBruno Michel
Apr 17, 2013·Pediatrics·Mari M NakamuraAshish K Jha
Apr 23, 2013·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Lesley A GraffCharles N Bernstein
Jun 8, 2013·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Omri GottesmanUNKNOWN eMERGE Network
Nov 30, 2013·BMJ Quality & Safety·Samuel T EdwardsDavid W Bates
Mar 4, 2014·Journal of Internal Medicine·A YasminaO H Klungel
Jul 23, 2014·The Annals of Pharmacotherapy·Elin C LehnbomJohanna I Westbrook
Aug 28, 2014·International Journal of Surgery·Gianluca PellinoFrancesco Selvaggi

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Citations

Mar 5, 2016·Inflammatory Bowel Diseases·Ashwin N AnanthakrishnanShawn N Murphy
May 16, 2017·Journal of Clinical Epidemiology·Paco M WelsingUNKNOWN Work Package 3 of the GetReal Consortium
Oct 1, 2018·Journal of Medical Systems·Clemens Scott KruseHarmander Kaur

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