Investigating the impact of disease and health record duration on the eMERGE algorithm for rheumatoid arthritis.

Journal of the American Medical Informatics Association : JAMIA
Vanessa L KronzerCynthia S Crowson

Abstract

The study sought to determine the dependence of the Electronic Medical Records and Genomics (eMERGE) rheumatoid arthritis (RA) algorithm on both RA and electronic health record (EHR) duration. Using a population-based cohort from the Mayo Clinic Biobank, we identified 497 patients with at least 1 RA diagnosis code. RA case status was manually determined using validated criteria for RA. RA duration was defined as time from first RA code to the index date of biobank enrollment. To simulate EHR duration, various years of EHR lookback were applied, starting at the index date and going backward. Model performance was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC). The eMERGE algorithm performed well in this cohort, with overall sensitivity 53%, specificity 99%, positive predictive value 97%, negative predictive value 74%, and AUC 76%. Among patients with RA duration <2 years, sensitivity and AUC were only 9% and 54%, respectively, but increased to 71% and 85% among patients with RA duration >10 years. Longer EHR lookback also improved model performance up to a threshold of 10 years, in which sensitivity reached 52% and AUC 75%. However, optimal EHR lookbac...Continue Reading

References

Mar 2, 2010·Arthritis and Rheumatism·Elena MyasoedovaSherine E Gabriel
Mar 18, 2010·Arthritis Care & Research·Katherine P LiaoRobert M Plenge
Apr 22, 2011·Science Translational Medicine·Abel N KhoJoshua C Denny
Mar 1, 2012·Journal of the American Medical Informatics Association : JAMIA·Robert J CarrollJoshua C Denny
Nov 20, 2012·International Journal of Epidemiology·Jennifer L St SauverWalter A Rocca
Sep 5, 2013·Mayo Clinic Proceedings·Janet E OlsonJames R Cerhan
Jan 26, 2016·Journal of Personalized Medicine·Jordan W SmollerScott T Weiss
Feb 26, 2016·Journal of the American Medical Informatics Association : JAMIA·Elizabeth FordJackie A Cassell

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