Improved Identification of Venous Thromboembolism From Electronic Medical Records Using a Novel Information Extraction Software Platform

INTRODUCTION:The United States federally mandated reporting of venous thromboembolism (VTE), defined by Agency for Healthcare Research & Quality Patient Safety Indicator 12 (AHRQ PSI-12), is based on administrative data, the accuracy of which has not been consistently demonstrated. We used IDEAL...

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Bibliographic Details
Published in:Medical care 2018-09, Vol.56 (9), p.e54-e60
Main Authors: Dantes, Raymund B, Zheng, Shuai, Lu, James J, Beckman, Michele G, Krishnaswamy, Asha, Richardson, Lisa C, Chernetsky-Tejedor, Sheri, Wang, Fusheng
Format: Article
Language:English
Subjects:
Electronic health records
Electronic medical records
Information retrieval
Software
Thromboembolism
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Summary:INTRODUCTION:The United States federally mandated reporting of venous thromboembolism (VTE), defined by Agency for Healthcare Research & Quality Patient Safety Indicator 12 (AHRQ PSI-12), is based on administrative data, the accuracy of which has not been consistently demonstrated. We used IDEAL-X, a novel information extraction software system, to identify VTE from electronic medical records and evaluated its accuracy. METHODS:Medical records for 13,248 patients admitted to an orthopedic specialty hospital from 2009 to 2014 were reviewed. Patient encounters were defined as a hospital admission where both surgery (of the spine, hip, or knee) and a radiology diagnostic study that could detect VTE was performed. Radiology reports were both manually reviewed by a physician and analyzed by IDEAL-X. RESULTS:Among 2083 radiology reports, IDEAL-X correctly identified 176/181 VTE events, achieving a sensitivity of 97.2% [95% confidence interval (CI), 93.7%–99.1%] and specificity of 99.3% (95% CI, 98.9%–99.7%) when compared with manual review. Among 422 surgical encounters with diagnostic radiographic studies for VTE, IDEAL-X correctly identified 41 of 42 VTE events, achieving a sensitivity of 97.6% (95% CI, 87.4%–99.6%) and specificity of 99.8% (95% CI, 98.7%–100.0%). The performance surpassed that of AHRQ PSI-12, which had a sensitivity of 92.9% (95% CI, 80.5%–98.4%) and specificity of 92.9% (95% CI, 89.8%–95.3%), though only the difference in specificity was statistically significant (P
ISSN:0025-7079
1537-1948
DOI:10.1097/MLR.0000000000000831