ArticleApplied clinical informatics2017
Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.
Article in Applied clinical informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Electronic health record data quality assessment and tools: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2023Pooled it
- Challenges in Identifying Heart Failure Diagnoses from the Electronic Health Record.Journal of cardiac failure - intersections · 2026Article
- Approaches to Collect Comprehensive Electronic Patient Data Across Multiple Providers and Payers for Research: Landscape Analysis.Journal of medical Internet research · 2026Article
- Article
- Diabetes Complications Among Community-Based Health Center Patients with Varying Multimorbidity Patterns.Journal of general internal medicine · 2025Article
- Optimal Surrogate-Assisted Sampling for Cost-Efficient Validation of Electronic Health Record Outcomes.Statistics in medicine · 2025Article
- Preparing for future pandemics: Automated intensive care electronic health record data extraction to accelerate clinical insights.Journal of intensive medicine · 2025Article
- Leveraging Large Language Models for Thyroid Nodule Information Extraction and Matching Across Medical Reports.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Healthcare utilization is a collider: an introduction to collider bias in EHR data reuse.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Accessing and utilizing clinical and genomic data from an electronic health record data warehouse.Translational medicine communications · 2023Article
- Developing Automated Computer Algorithms to Phenotype Periodontal Disease Diagnoses in Electronic Dental Records.Methods of information in medicine · 2022Article
- Comparing ascertainment of chronic condition status with problem lists versus encounter diagnoses from electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Comparing reliability of ICD-10-based COVID-19 comorbidity data to manual chart review, a retrospective cross-sectional study.Journal of medical virology · 2022Article
- Subcategorizing EHR diagnosis codes to improve clinical application of machine learning models.International journal of medical informatics · 2021Article
- A systematic review of risk stratification tools internationally used in primary care settings.Health science reports · 2021Review
- Characteristics and Disease Severity of US Children and Adolescents Diagnosed With COVID-19.JAMA network open · 2021Article
- Primary care practices' ability to predict future risk of expenditures and hospitalization using risk stratification and segmentation.BMC medical informatics and decision making · 2021Article
- Measuring problem prescription opioid use among patients receiving long-term opioid analgesic treatment: development and evaluation of an algorithm for use in EHR and claims data.Journal of drug assessment · 2020Article
- Towards augmenting structured EHR data: a comparison of manual chart review and patient self-report.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses.
methodsAdults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization.
resultsNine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard.
conclusionsEHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.