Details:

Alternative Title:
BMJ
Publisher's site:
http://dx.doi.org/
Personal Author:
Reis, Ben Y ; Kohane, Isaac S ; Mandl, Kenneth D
Reis, Ben Y ; Kohane, Isaac S ; Mandl, Kenneth D Less -
Description:
To determine whether longitudinal data in patients' historical records, commonly available in electronic health record systems, can be used to predict a patient's future risk of receiving a diagnosis of domestic abuse.|Bayesian models, known as intelligent histories, used to predict a patient's risk of receiving a future diagnosis of abuse, based on the patient's diagnostic history. Retrospective evaluation of the model's predictions using an independent testing set.|A state-wide claims database covering six years of inpatient admissions to hospital, admissions for observation, and encounters in emergency departments. Population All patients aged over 18 who had at least four years between their earliest and latest visits recorded in the database (561,216 patients).|Timeliness of detection, sensitivity, specificity, positive predictive values, and area under the ROC curve.|1.04% (5829) of the patients met the narrow case definition for abuse, while 3.44% (19,303) met the broader case definition for abuse. The model achieved sensitive, specific (area under the ROC curve of 0.88), and early (10-30 months in advance, on average) prediction of patients' future risk of receiving a diagnosis of abuse. Analysis of model parameters showed important differences between sexes in the risks associated with certain diagnoses.|Commonly available longitudinal diagnostic data can be useful for predicting a patient's future risk of receiving a diagnosis of abuse. This modelling approach could serve as the basis for an early warning system to help doctors identify high risk patients for further screening.
Subject:
[+]
Adult
Aged
Domestic Violence
Early Diagnosis
Female
Humans
Male
Medical History Taking
Medical Records
Middle Aged
Models, Theoretical
Predictive Value Of Tests
Research
Risk Assessment
ROC Curve
Young Adult

Source:
BMJ. 339.
Pubmed ID:
19789406
Pubmed Central ID:
PMC2755036
Document Type:
Journal Article
Funding:
G08LM009778/LM/NLM NIH HHS/United States ; R01 LM007677/LM/NLM NIH HHS/United States ; R01 LM009879/LM/NLM NIH HHS/United States ; R01 LM009879/LM/NLM NIH HHS/United States ; R01 LM009879-01A1/LM/NLM NIH HHS/United States ; ... More +
G08LM009778/LM/NLM NIH HHS/United States ; R01 LM007677/LM/NLM NIH HHS/United States ; R01 LM009879/LM/NLM NIH HHS/United States ; R01 LM009879/LM/NLM NIH HHS/United States ; R01 LM009879-01A1/LM/NLM NIH HHS/United States ; R01 PH000040/PH/PHPPO CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:fedbfb9c6908f055797bc94dd0729e9acafbcb34949ed34a3b29ad0bf306e13e
File Type:

Supporting Files

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