PMID- 22249968
OWN - NLM
STAT- MEDLINE
DCOM- 20120511
LR  - 20220321
IS  - 1527-974X (Electronic)
IS  - 1067-5027 (Print)
IS  - 1067-5027 (Linking)
VI  - 19
IP  - 2
DP  - 2012 Mar-Apr
TI  - Impact of data fragmentation across healthcare centers on the accuracy of a 
      high-throughput clinical phenotyping algorithm for specifying subjects with type 
      2 diabetes mellitus.
PG  - 219-24
LID - 10.1136/amiajnl-2011-000597 [doi]
AB  - OBJECTIVE: To evaluate data fragmentation across healthcare centers with regard 
      to the accuracy of a high-throughput clinical phenotyping (HTCP) algorithm 
      developed to differentiate (1) patients with type 2 diabetes mellitus (T2DM) and 
      (2) patients with no diabetes. MATERIALS AND METHODS: This population-based study 
      identified all Olmsted County, Minnesota residents in 2007. We used 
      provider-linked electronic medical record data from the two healthcare centers 
      that provide >95% of all care to County residents (ie, Olmsted Medical Center and 
      Mayo Clinic in Rochester, Minnesota, USA). Subjects were limited to residents 
      with one or more encounter January 1, 2006 through December 31, 2007 at both 
      healthcare centers. DM-relevant data on diagnoses, laboratory results, and 
      medication from both centers were obtained during this period. The algorithm was 
      first executed using data from both centers (ie, the gold standard) and then from 
      Mayo Clinic alone. Positive predictive values and false-negative rates were 
      calculated, and the McNemar test was used to compare categorization when data 
      from the Mayo Clinic alone were used with the gold standard. Age and sex were 
      compared between true-positive and false-negative subjects with T2DM. Statistical 
      significance was accepted as p<0.05. RESULTS: With data from both medical 
      centers, 765 subjects with T2DM (4256 non-DM subjects) were identified. When 
      single-center data were used, 252 T2DM subjects (1573 non-DM subjects) were 
      missed; an additional false-positive 27 T2DM subjects (215 non-DM subjects) were 
      identified. The positive predictive values and false-negative rates were 95.0% 
      (513/540) and 32.9% (252/765), respectively, for T2DM subjects and 92.6% 
      (2683/2898) and 37.0% (1573/4256), respectively, for non-DM subjects. Age and sex 
      distribution differed between true-positive (mean age 62.1; 45% female) and 
      false-negative (mean age 65.0; 56.0% female) T2DM subjects. CONCLUSION: The 
      findings show that application of an HTCP algorithm using data from a single 
      medical center contributes to misclassification. These findings should be 
      considered carefully by researchers when developing and executing HTCP 
      algorithms.
FAU - Wei, Wei-Qi
AU  - Wei WQ
AD  - Institute for Health Informatics, University of Minnesota, Twin Cities, 
      Minnesota, USA.
FAU - Leibson, Cynthia L
AU  - Leibson CL
FAU - Ransom, Jeanine E
AU  - Ransom JE
FAU - Kho, Abel N
AU  - Kho AN
FAU - Caraballo, Pedro J
AU  - Caraballo PJ
FAU - Chai, High Seng
AU  - Chai HS
FAU - Yawn, Barbara P
AU  - Yawn BP
FAU - Pacheco, Jennifer A
AU  - Pacheco JA
FAU - Chute, Christopher G
AU  - Chute CG
LA  - eng
GR  - U01 HG004599/HG/NHGRI NIH HHS/United States
GR  - U01 HG04599/HG/NHGRI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20120116
PL  - England
TA  - J Am Med Inform Assoc
JT  - Journal of the American Medical Informatics Association : JAMIA
JID - 9430800
SB  - IM
MH  - Age Distribution
MH  - *Algorithms
MH  - Ambulatory Care Facilities
MH  - Diabetes Mellitus, Type 2/classification/*diagnosis/genetics
MH  - Diagnostic Errors
MH  - Female
MH  - Humans
MH  - Male
MH  - Minnesota
MH  - *Phenotype
MH  - Predictive Value of Tests
MH  - Sex Distribution
PMC - PMC3277630
COIS- Competing interests: None.
EDAT- 2012/01/18 06:00
MHDA- 2012/05/12 06:00
PMCR- 2013/03/01
CRDT- 2012/01/18 06:00
PHST- 2012/01/18 06:00 [entrez]
PHST- 2012/01/18 06:00 [pubmed]
PHST- 2012/05/12 06:00 [medline]
PHST- 2013/03/01 00:00 [pmc-release]
AID - amiajnl-2011-000597 [pii]
AID - 10.1136/amiajnl-2011-000597 [doi]
PST - ppublish
SO  - J Am Med Inform Assoc. 2012 Mar-Apr;19(2):219-24. doi: 
      10.1136/amiajnl-2011-000597. Epub 2012 Jan 16.