ArticleJournal of traumatic stress2019
Validation of an Electronic Medical Record-Based Algorithm for Identifying Posttraumatic Stress Disorder in U.S. Veterans.
Article in Journal of traumatic stress, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Understanding the comorbidity between posttraumatic stress severity and coronary artery disease using genome-wide information and electronic health records.Molecular psychiatry · 2022Pooled it
- Implementing Precision Psychiatry: A Systematic Review of Individualized Prediction Models for Clinical Practice.Schizophrenia bulletin · 2021Pooled it
- Impact of posttraumatic stress disorder on incident cardiovascular outcomes in women veterans: a retrospective longitudinal study.EClinicalMedicine · 2026Article
- Depression, anxiety, and post-traumatic stress disorder in pregnancies among Métis people in Alberta: a population-based cross-sectional study.BMC global and public health · 2026Article
- Misleading Results in Posttraumatic Stress Disorder Predictive Models Using Electronic Health Record Data: Algorithm Validation Study.Journal of medical Internet research · 2025Article
- Trauma, posttraumatic stress disorder, and incident chronic disease.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Shared genetic risk and causal associations between Post-traumatic stress disorder and migraine with antithrombotic agents and other medications.Neurobiology of stress · 2025Article
- Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome.Biological psychiatry global open science · 2024Article
- Centralized Interactive Phenomics Resource: an integrated online phenomics knowledgebase for health data users.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- No Replication of Alzheimer's Disease Genetics as a Moderator of Combat Exposure's Association with PTSD risk in 138,592 Combat Veterans.Nature. Mental health · 2024Article
- Posttraumatic Stress Disorder Is Associated With Elevated Risk of Incident Stroke and Transient Ischemic Attack in Women Veterans.Journal of the American Heart Association · 2024Article
- Pathways Linking Post-Traumatic Stress Disorder to Incident Ischemic Heart Disease in Women: Call to Action.JACC. Advances · 2024Article
- Development and validation of a machine learning model using electronic health records to predict trauma- and stressor-related psychiatric disorders after hospitalization with sepsis.Translational psychiatry · 2023Article
- Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome.medRxiv : the preprint server for health sciences · 2023Article
- Lifelong Association of Disorders Related to Military Trauma with Subsequent Parkinson's Disease.Movement disorders : official journal of the Movement Disorder Society · 2023Article
- Alzheimer's disease and related dementias among aging veterans: Examining gene-by-environment interactions with post-traumatic stress disorder and traumatic brain injury.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Framework of the Centralized Interactive Phenomics Resource (CIPHER) standard for electronic health data-based phenomics knowledgebase.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Pan-Canadian Electronic Medical Record Diagnostic and Unstructured Text Data for Capturing PTSD: Retrospective Observational Study.JMIR medical informatics · 2022Article
- Posttraumatic Stress Disorder Does Not Compromise Behavioral Pain Treatment: Secondary Analysis of a Randomized Clinical Trial Among Veterans.Global advances in health and medicine · 2022Article
- Feasibility of Extracting Meaningful Patient Centered Outcomes From the Electronic Health Record Following Critical Illness in the Elderly.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
We developed an algorithm for identifying U.S. veterans with a history of posttraumatic stress disorder (PTSD), using the Department of Veterans Affairs (VA) electronic medical record (EMR) system. This work was motivated by the need to create a valid EMR-based phenotype to identify thousands of cases and controls for a genome-wide association study of PTSD in veterans. We used manual chart review (n = 500) as the gold standard. For both the algorithm and chart review, three classifications were possible: likely PTSD, possible PTSD, and likely not PTSD. We used Lasso regression with cross-validation to select statistically significant predictors of PTSD from the EMR and then generate a predicted probability score of being a PTSD case for every participant in the study population (range: 0-1.00). Comparing the performance of our probabilistic approach (Lasso algorithm) to a rule-based approach (International Classification of Diseases [ICD] algorithm), the Lasso algorithm showed modestly higher overall percent agreement with chart review than the ICD algorithm (80% vs. 75%), higher sensitivity (0.95 vs. 0.84), and higher accuracy (AUC = 0.95 vs. 0.90). We applied a 0.7 probability cut-point to the Lasso results to determine final PTSD case-control status for the VA population. The final algorithm had a 0.99 sensitivity, 0.99 specificity, 0.95 positive predictive value, and 1.00 negative predictive value for PTSD classification (grouping possible PTSD and likely not PTSD) as determined by chart review. This algorithm may be useful for other research and quality improvement endeavors within the VA.
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Registered trials
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