Evidence map›Paper›PMID 30541125›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2018

Detecting moderate or complex congenital heart defects in adults from an electronic health records system.

Alpha Oumar Diallo, Asha Krishnaswamy, Stuart K Shapira, Matthew E Oster, Mary G George, Jenna C Adams, Elizabeth R Walker, Paul Weiss, Mohammed K Ali, Wendy Book

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Alpha Oumar DialloDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Asha KrishnaswamyNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Stuart K ShapiraNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Matthew E OsterDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Mary G GeorgeNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jenna C AdamsEmory University School of Medicine, Atlanta, GA, USA.
Elizabeth R WalkerEmory University School of Medicine, Atlanta, GA, USA.
Paul WeissDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Mohammed K AliDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Wendy BookEmory University School of Medicine, Atlanta, GA, USA.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
J: NRSA Training CoreTL1TR002382 · NCATS · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Vasiliki Michopoulos · 2017 to 2026
$8.5M
Intramural CDC HHS CC999999NCATS NIH HHS TL1 TR002382NCATS NIH HHS UL1 TR002378
6 · The paper itself

Abstract

Background: The prevalence of moderate or complex (moderate-complex) congenital heart defects (CHDs) among adults is increasing due to improved survival, but many patients experience lapses in specialty care or their CHDs are undocumented in the medical system. There is, to date, no efficient approach to identify this population. Objective: To develop and assess the performance of a risk score to identify adults aged 20-60 years with undocumented specific moderate-complex CHDs from electronic health records (EHR). Methods: We used a case-control study (596 adults with specific moderate-complex CHDs and 2384 controls). We extracted age, race/ethnicity, electrocardiogram (EKG), and blood tests from routine outpatient visits (1/2009 through 12/2012). We used multivariable logistic regression models and a split-sample (4: 1 ratio) approach to develop and internally validate the risk score, respectively. We generated receiver operating characteristic (ROC) c-statistics and Brier scores to assess the ability of models to predict the presence of specific moderate-complex CHDs. Results: Out of six models, the non-blood biomarker model that included age, sex, and EKG parameters offered a high ROC c-statistic of 0.96 [95% confidence interval: 0.95, 0.97] and low Brier score (0.05) relative to the other models. The adult moderate-complex congenital heart defect risk score demonstrated good accuracy with 96.4% sensitivity and 80.0% specificity at a threshold score of 10. Conclusions: A simple risk score based on age, sex, and EKG parameters offers early proof of concept and may help accurately identify adults with specific moderate-complex CHDs from routine EHR systems who may benefit from specialty care.

Indexed as

AlgorithmsElectrocardiographyElectronic Health RecordsAdultAge FactorsBiomarkersCase-Control StudiesFemaleHeart Defects, CongenitalHumansLogistic ModelsMaleMiddle AgedRiskROC CurveSex FactorsBiomarkers

Identifiers

PMID30541125
PMCPMC6319253

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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.