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Use of administrative and electronic health record data for development of automated algorithms for childhood diabetes case ascertainment and type classification: the SEARCH for Diabetes in Youth Study
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Jun 09 2014
Source: Pediatr Diabetes. 15(8):573-584. -
Alternative Title:Pediatr Diabetes
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Description:Background
The performance of automated algorithms for childhood diabetes case ascertainment and type classification may differ by demographic characteristics.
Objective
This study evaluated the potential of administrative and electronic health record (EHR) data from a large academic care delivery system to conduct diabetes case ascertainment in youth according to type, age and race/ethnicity.
Subjects
57,767 children aged <20 years as of December 31, 2011 seen at University of North Carolina Health Care System in 2011 were included.
Methods
Using an initial algorithm including billing data, patient problem lists, laboratory test results and diabetes related medications between July 1, 2008 and December 31, 2011, presumptive cases were identified and validated by chart review. More refined algorithms were evaluated by type (type 1 versus type 2), age (<10 versus ≥10 years) and race/ethnicity (non-Hispanic white versus “other”). Sensitivity, specificity and positive predictive value were calculated and compared.
Results
The best algorithm for ascertainment of diabetes cases overall was billing data. The best type 1 algorithm was the ratio of the number of type 1 billing codes to the sum of type 1 and type 2 billing codes ≥0.5. A useful algorithm to ascertain type 2 youth with “other” race/ethnicity was identified. Considerable age and racial/ethnic differences were present in type-non-specific and type 2 algorithms.
Conclusions
Administrative and EHR data may be used to identify cases of childhood diabetes (any type), and to identify type 1 cases. The performance of type 2 case ascertainment algorithms differed substantially by race/ethnicity.
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Pubmed ID:24913103
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Pubmed Central ID:PMC4229415
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