Evidence map›Paper›PMID 35092276›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2022

Respiratory support status from EHR data for adult population: classification, heuristics, and usage in predictive modeling.

Sean C Yu, Mackenzie R Hofford, Albert M Lai, Marin H Kollef, Philip R O Payne, Andrew P Michelson

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

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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

6 authors.

Sean C YuDepartment of Biomedical Engineering, School of Engineering, Washington University School in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0002-1434-8556
Mackenzie R HoffordInstitute for Informatics, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0001-8256-2127
Albert M LaiInstitute for Informatics, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0002-9241-2656
Marin H KollefDivision of Pulmonary and Critical Care, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Philip R O PayneInstitute for Informatics, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.ORCID 0000-0002-9532-2998
Andrew P MichelsonInstitute for Informatics, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRespiratory support status is critical in understanding patient status, but electronic health record data are often scattered, incomplete, and contradictory. Further, there has been limited work on standardizing representations for respiratory support. The objective of this work was to (1) propose a practical terminology system for respiratory support methods; (2) develop (meta-)heuristics for constructing respiratory support episodes; and (3) evaluate the utility of respiratory support information for mortality prediction. MATERIALS AND

methodsAll analyses were performed using electronic health record data of COVID-19-tested, emergency department-admit, adult patients at a large, Midwestern healthcare system between March 1, 2020 and April 1, 2021. Logistic regression and XGBoost models were trained with and without respiratory support information, and performance metrics were compared. Importance of respiratory-support-based features was explored using absolute coefficient values for logistic regression and SHapley Additive exPlanations values for the XGBoost model.

resultsThe proposed terminology system for respiratory support methods is as follows: Low-Flow Oxygen Therapy (LFOT), High-Flow Oxygen Therapy (HFOT), Non-Invasive Mechanical Ventilation (NIMV), Invasive Mechanical Ventilation (IMV), and ExtraCorporeal Membrane Oxygenation (ECMO). The addition of respiratory support information significantly improved mortality prediction (logistic regression area under receiver operating characteristic curve, median [IQR] from 0.855 [0.852-0.855] to 0.881 [0.876-0.884]; area under precision recall curve from 0.262 [0.245-0.268] to 0.319 [0.313-0.325], both P < 0.01). The proposed generalizable, interpretable, and episodic representation had commensurate performance compared to alternate representations despite loss of granularity. Respiratory support features were among the most important in both models.

conclusionRespiratory support information is critical in understanding patient status and can facilitate downstream analyses.

Indexed as

COVID-19HeuristicsAdultHumansMachine LearningOxygenRetrospective StudiesOxygenelectronic health recordsmachine learningoxygen supportpredictive analyticsrespiratory supportsupplemental oxygen

Identifiers

PMID35092276
PMCPMC9006699

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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.