Characterizing clinical findings of Sjögren's Disease patients in community practices using matched electronic dental-health record data

• Published in: PloS one 2023-07, Vol.18 (7), p.e0289335-e0289335
• Main Authors: Felix Gomez, Grace Gomez, Hugenberg, Steven T, Zunt, Susan, Patel, Jay S, Wang, Mei, Rajapuri, Anushri Singh, Lembcke, Lauren R, Rajendran, Divya, Smith, Jonas C, Cheriyan, Biju, Boyd, LaKeisha J, Eckert, George J, Grannis, Shaun J, Srinivasan, Mythily, Zero, Domenick T, Thyvalikakath, Thankam P
• Format: Article
• Language: English
• Subjects: Analysis; Antibodies; Antibodies, Antinuclear; Autoimmune diseases; Biology and Life Sciences; Biopsy; Care and treatment; Chi-square test; Classification; Clinical outcomes; Codes; Comorbidity; Computational linguistics; Computer and Information Sciences; Criteria; Data exchange; Dental care; Dental disorders; Dentistry; Dentists; Diagnosis; Diagnostic systems; Disease; Dry Eye Syndromes; Electronic health records; Electronic medical records; Electronic records; Evidence-based medicine; Exocrine glands; Health; Health Information Exchange; Humans; Immune system; Language processing; Longitudinal studies; Medical diagnosis; Medical records; Medical research; Medicine and Health Sciences; Medicine, Experimental; Natural language interfaces; Oral hygiene; Patients; Physicians; Population; Quality of Life; Radiation; Respiratory distress syndrome; Ro(SSA) antigen; Serology; Signs and symptoms; Sjogren's syndrome; Sjogren's Syndrome - diagnosis; Sjogren's Syndrome - epidemiology; Viral antibodies
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0289335

Established classifications exist to confirm Sjögren's Disease (SD) (previously referred as Sjögren's Syndrome) and recruit patients for research. However, no established classification exists for diagnosis in clinical settings causing delayed diagnosis. SD patients experience a huge dental disease burden impairing their quality of life. This study established criteria to characterize Indiana University School of Dentistry (IUSD) patients' SD based on symptoms and signs in the electronic health record (EHR) data available through the state-wide Indiana health information exchange (IHIE). Association between SD diagnosis, and comorbidities including other autoimmune conditions, and documentation of SD diagnosis in electronic dental record (EDR) were also determined. The IUSD patients' EDR were linked with their EHR data in the IHIE and queried for SD diagnostic ICD9/10 codes. The resulting cohorts' EHR clinical findings were characterized and classified using diagnostic criteria based on clinical experts' recommendations. Descriptive statistics were performed, and Chi-square tests determined the association between the different SD presentations and comorbidities including other autoimmune conditions. Eighty-three percent of IUSD patients had an EHR of which 377 patients had a SD diagnosis. They were characterized as positive (24%), uncertain (20%) and negative (56%) based on EHR clinical findings. Dry eyes and mouth were reported for 51% and positive Anti-Ro/SSA antibodies and anti-nuclear antibody (ANA) for 17% of this study cohort. One comorbidity was present in 98% and other autoimmune condition/s were present in 53% respectively. Significant differences were observed between the three SD clinical characteristics/classifications and certain medical and autoimmune conditions (p