Evidence map›Paper›PMID 30043122›Full record

ArticleJournal of medical systems2018

Development of an Algorithm to Identify Cannabis Urine Drug Test Results within a Multi-Site Electronic Health Record System.

Benjamin J Morasco, Sarah E Shull, Melissa H Adams, Steven K Dobscha, Travis I Lovejoy

Abstract read
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In one paragraph

Article in Journal of medical systems, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Benjamin J MorascoCenter to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D99), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA. benjamin.morasco@va.gov.
Sarah E ShullCenter to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D99), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
Melissa H AdamsCenter to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D99), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
Steven K DobschaCenter to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D99), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
Travis I LovejoyCenter to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D99), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA.

Funding

Correlates and outcomes of opioid dose escalation among chronic pain patientsR01DA034083 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI MORASCO, BENJAMIN J. · 2013 to 2017
$2.4M
Chronic Pain Management in Veterans with Co-occurring Substance Use DisordersIK2HX001516 · VA · PORTLAND VA MEDICAL CENTER · PI LOVEJOY, TRAVIS IAN · 2015 to 2019
–
HSRD VA IK2 HX001516NIH HHS R01DA034083VA Health Services Research & Development 1I01HX001583
6 · The paper itself

Abstract

With the rapid changes in the legalization of cannabis in the U.S., there is an urgent need to understand clinical outcomes and processes of care among patients who use cannabis, particularly among patients with chronic pain who are high utilizers of cannabis. Electronic health records (EHRs) are a common and convenient mechanism for examining processes of care; however, there is not an indication for cannabis use that does not meet criteria for a diagnostic disorder. We used urine drug test (UDT) results identified through EHRs to identify patients with confirmed cannabis use. We developed and tested an algorithm to identify outcomes of UDT results for cannabis because there is wide variability in reporting methodology, including in multi-site health systems. Among all patients receiving care in the Department of Veterans Affairs (VA) who were prescribed long-term opioid therapy for chronic pain, we identified a random sample who completed UDT for cannabis. Through an iterative process, we developed an algorithm to identify UDT cannabis results. Manual review of EHR data was conducted to verify accuracy of UDT results. The final UDT algorithm correctly identified 99% of cannabis positive UDT results and 100% of cannabis negative UDT results among 200 randomly sampled patients. Study findings suggest a high degree of accuracy for using an algorithm to identify samples of patients with positive cannabis UDT results across multiple institutions with disparate UDT reporting practices. The methodology for testing this algorithm is feasible and may be applied to other multi-site health systems.

Indexed as

AlgorithmsElectronic Health RecordsMedical MarijuanaAnalgesics, OpioidCannabisChronic PainHumansMarijuana SmokingSubstance Abuse DetectionUnited StatesUrinalysisAnalgesics, OpioidMedical MarijuanaAlgorithmCannabisElectronic health recordUrine drug test

Identifiers

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Registered trials

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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.