Title |
Intra-database validation of case-identifying algorithms using reconstituted electronic health records from healthcare claims data
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Published in |
BMC Medical Research Methodology, May 2021
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DOI | 10.1186/s12874-021-01285-y |
Pubmed ID | |
Authors |
Nicolas H. Thurin, Pauline Bosco-Levy, Patrick Blin, Magali Rouyer, Jérémy Jové, Stéphanie Lamarque, Séverine Lignot, Régis Lassalle, Abdelilah Abouelfath, Emmanuelle Bignon, Pauline Diez, Marine Gross-Goupil, Michel Soulié, Mathieu Roumiguié, Sylvestre Le Moulec, Marc Debouverie, Bruno Brochet, Francis Guillemin, Céline Louapre, Elisabeth Maillart, Olivier Heinzlef, Nicholas Moore, Cécile Droz-Perroteau |
Abstract |
Diagnosis performances of case-identifying algorithms developed in healthcare database are usually assessed by comparing identified cases with an external data source. When this is not feasible, intra-database validation can present an appropriate alternative. To illustrate through two practical examples how to perform intra-database validations of case-identifying algorithms using reconstituted Electronic Health Records (rEHRs). Patients with 1) multiple sclerosis (MS) relapses and 2) metastatic castration-resistant prostate cancer (mCRPC) were identified in the French nationwide healthcare database (SNDS) using two case-identifying algorithms. A validation study was then conducted to estimate diagnostic performances of these algorithms through the calculation of their positive predictive value (PPV) and negative predictive value (NPV). To that end, anonymized rEHRs were generated based on the overall information captured in the SNDS over time (e.g. procedure, hospital stays, drug dispensing, medical visits) for a random selection of patients identified as cases or non-cases according to the predefined algorithms. For each disease, an independent validation committee reviewed the rEHRs of 100 cases and 100 non-cases in order to adjudicate on the status of the selected patients (true case/ true non-case), blinded with respect to the result of the corresponding algorithm. Algorithm for relapses identification in MS showed a 95% PPV and 100% NPV. Algorithm for mCRPC identification showed a 97% PPV and 99% NPV. The use of rEHRs to conduct an intra-database validation appears to be a valuable tool to estimate the performances of a case-identifying algorithm and assess its validity, in the absence of alternative. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
France | 2 | 33% |
Japan | 1 | 17% |
Portugal | 1 | 17% |
Unknown | 2 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 5 | 83% |
Practitioners (doctors, other healthcare professionals) | 1 | 17% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 24 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 3 | 13% |
Professor > Associate Professor | 2 | 8% |
Researcher | 2 | 8% |
Student > Ph. D. Student | 2 | 8% |
Other | 1 | 4% |
Other | 2 | 8% |
Unknown | 12 | 50% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 3 | 13% |
Computer Science | 2 | 8% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
Psychology | 1 | 4% |
Nursing and Health Professions | 1 | 4% |
Other | 2 | 8% |
Unknown | 14 | 58% |