Abstract:
OBJECTIVE:Venous thromboembolism (VTE) prophylaxis is an important consideration for hospitalized older adults, and the Padua Prediction Score (PPS) is a risk prediction tool used to prioritize patient selection. We developed an automated PPS (APPS) algorithm using electronic health record (EHR) data. This study examines the accuracy of APPS and its individual components versus manual data extraction. METHODS:This is a retrospective cohort study of hospitalized general internal medicine patients, aged 70 and over. Fourteen clinical variables were collected to determine their PPS; APPS used EHR data exports from health system databases, and a trained abstractor performed manual chart abstractions. We calculated sensitivity and specificity of the APPS, using manual PPS as the gold standard for classifying risk category (low vs. high). We also examined performance characteristics of the APPS for individual variables. RESULTS:PPS was calculated by both methods on 311 individuals. The mean PPS was 3.6 (standard deviation, 1.8) for manual abstraction and 2.8 (1.4) for APPS. In detecting patients at high risk for VTE, the sensitivity and specificity of the APPS algorithm were 46 and 94%, respectively. The sensitivity for APPS was poor (range: 6-34%) for detecting acute conditions (i.e., acute myocardial infarction), moderate (range: 52-74%) for chronic conditions (i.e., heart failure), and excellent (range: 94-98%) for conditions of obesity and restricted mobility. Specificity of the automated extraction method for each PPS variable was > 87%. CONCLUSION:APPS as a stand-alone tool was suboptimal for classifying risk of VTE occurrence. The APPS accurately identified high risk patients (true positives), but lower scores were considered indeterminate.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Pavon JM,Sloane RJ,Pieper CF,Colón-Emeric CS,Cohen HJ,Gallagher D,Morey MC,McCarty M,Ortel TL,Hastings SNdoi
10.1055/s-0038-1670678subject
Has Abstractpub_date
2018-07-01 00:00:00pages
743-751issue
3issn
1869-0327journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Hospitals across the country are investing millions of dollars to adopt new Health Insurance Portability and Accountability Act (HIPAA)-compliant secure text messaging systems. However, in nearly all cases, these implementations are occurring without evaluation of their impact on patient care. OBJECTIVE:To ...
journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
pub_type: 杂志文章
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
pub_type: 杂志文章
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更新日期:2010-08-04 00:00:00
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pub_type: 杂志文章
doi:10.1055/s-0040-1715895
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
pub_type: 杂志文章
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journal_title:Applied clinical informatics
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journal_title:Applied clinical informatics
pub_type: 杂志文章
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