Develop and validate a computable phenotype for the identification of Alzheimer's disease patients using electronic health record data

Author:

He Xing1ORCID,Wei Ruoqi1,Huang Yu1,Chen Zhaoyi2,Lyu Tianchen1,Bost Sarah1,Tong Jiayi3,Li Lu3,Zhou Yujia4,Li Zhao5,Guo Jingchuan6,Tang Huilin6,Wang Fei7,DeKosky Steven8,Xu Hua4,Chen Yong3,Zhang Rui9,Xu Jie1,Guo Yi1,Wu Yonghui1,Bian Jiang1ORCID

Affiliation:

1. Department of Health Outcomes & Biomedical Informatics College of Medicine University of Florida Gainesville Florida USA

2. Center for Biomedical Informatics & Information Technology National Cancer Institute Rockville Maryland USA

3. Department of Biostatistics, Epidemiology and Informatics University of Pennsylvania Philadelphia Pennsylvania USA

4. Biomedical Informatics and Data Science School of Medicine, Yale New Haven Connecticut USA

5. School of Biomedical Informatics University of Texas Health Science Center at Houston Houston Texas USA

6. Department of Pharmaceutical Outcomes and Policy College of Pharmacy University of Florida Gainesville Florida USA

7. Department of Population Health Sciences Weill Cornell Medicine New York New York USA

8. Department of Neurology College of Medicine University of Florida Gainesville Florida USA

9. Division of Computational Health Sciences Department of Surgery University of Minnesota Minneapolis Minnesota USA

Abstract

AbstractINTRODUCTIONAlzheimer's disease (AD) is often misclassified in electronic health records (EHRs) when relying solely on diagnosis codes. This study aimed to develop a more accurate, computable phenotype (CP) for identifying AD patients using structured and unstructured EHR data.METHODSWe used EHRs from the University of Florida Health (UFHealth) system and created rule‐based CPs iteratively through manual chart reviews. The CPs were then validated using data from the University of Texas Health Science Center at Houston (UTHealth) and the University of Minnesota (UMN).RESULTSOur best‐performing CP was “patient has at least 2 AD diagnoses and AD‐related keywords in AD encounters,” with an F1‐score of 0.817 at UF, 0.961 at UTHealth, and 0.623 at UMN, respectively.DISCUSSIONWe developed and validated rule‐based CPs for AD identification with good performance, which will be crucial for studies that aim to use real‐world data like EHRs.Highlights Developed a computable phenotype (CP) to identify Alzheimer's disease (AD) patients using EHR data. Utilized both structured and unstructured EHR data to enhance CP accuracy. Achieved a high F1‐score of 0.817 at UFHealth, and 0.961 and 0.623 at UTHealth and UMN. Validated the CP across different demographics, ensuring robustness and fairness.

Funder

National Institute on Aging

Publisher

Wiley

Reference32 articles.

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