ArticleJournal of the American Medical Informatics Association : JAMIA2022
Comparing ascertainment of chronic condition status with problem lists versus encounter diagnoses from electronic health records.
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 22 papers.
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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
22 citing papers in PubMed, 33 citations in OpenAlex.
- Validating ICD code case definitions for condition case ascertainment in multimorbidity measurement: a retrospective chart review.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Electronic health records research: easy evidence, harder oversight.European heart journal. Digital health · 2026Article
- Current state of electronic problems lists in primary care: a rapid scoping review.Family practice · 2026Article
- Deterministic Overlapping Multimorbidity Phenotypes for Leakage-Safe EHR Modeling of Incident Cognitive Impairment in All of Us.Journal of interdisciplinary research applied to medicine · 2026Article
- Evaluation of the genome-informed risk assessment (GIRA) approach from eMERGE in an independent health system.medRxiv : the preprint server for health sciences · 2026Article
- A retrieval-augmented generation large language model framework for accurate dementia identification from electronic health records.medRxiv : the preprint server for health sciences · 2026Article
- Epidemiologic Method Review at Scale: Assessing Charlson Comorbidity Versioning Using a Large Language Model.medRxiv : the preprint server for health sciences · 2025Article
- Accuracy of Electronic Health Record-Based Definitions for Patients with Heart Failure.The American journal of medicine · 2025Article
- Child and youth chronic physical health conditions: a comparison of survey data and linked administrative health data in Ontario.BMC pediatrics · 2025Article
- Racial Inequality in Receipt of Medications for Opioid Use Disorder in Nationwide Outpatient Settings-A Cross-sectional Study.Journal of general internal medicine · 2025Observational
- Novel Electronic Health Record Strategies to Identify Frailty Among Hospitalized Older Adults with Multiple Chronic Conditions.Journal of general internal medicine · 2025Article
- Diabetes Complications Among Community-Based Health Center Patients with Varying Multimorbidity Patterns.Journal of general internal medicine · 2025Article
- Capturing the care of complex community-based health center patients: A comparison of multimorbidity indices and clinical classification software.Health services research · 2025Article
- Social Deprivation and Multimorbidity Among Community-Based Health Center Patients in the United States.Preventing chronic disease · 2024Article
- Impact of Health Insurance Patterns on Chronic Health Conditions Among Older Patients.Journal of the American Board of Family Medicine : JABFM · 2023Article
- Impact of data source choice on multimorbidity measurement: a comparison study of 2.3 million individuals in the Welsh National Health Service.BMC medicine · 2023Article
- Diagnosing major depressive disorder and substance use disorder using the electronic health record: A preliminary validation study.Journal of mood and anxiety disorders · 2023Article
- Clinical encounter heterogeneity and methods for resolving in networked EHR data: a study from N3C and RECOVER programs.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Trajectories of Chronic Disease and Multimorbidity Among Middle-aged and Older Patients at Community Health Centers.JAMA network open · 2023Article
- Accessing and utilizing clinical and genomic data from an electronic health record data warehouse.Translational medicine communications · 2023Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo assess and compare electronic health record (EHR) documentation of chronic disease in problem lists and encounter diagnosis records among Community Health Center (CHC) patients. MATERIALS AND
methodsWe assessed patient EHR data in a large clinical research network during 2012-2019. We included CHCs who provided outpatient, older adult primary care to patients age ≥45 years, with ≥2 office visits during the study. Our study sample included 1 180 290 patients from 545 CHCs across 22 states. We used diagnosis codes from 39 Chronic Condition Warehouse algorithms to identify chronic conditions from encounter diagnoses only and compared against problem list records. We measured correspondence including agreement, kappa, prevalence index, bias index, and prevalence-adjusted bias-adjusted kappa.
resultsOverlap of encounter diagnosis and problem list ascertainment was 59.4% among chronic conditions identified, with 12.2% of conditions identified only in encounters and 28.4% identified only in problem lists. Rates of coidentification varied by condition from 7.1% to 84.4%. Greatest agreement was found in diabetes (84.4%), HIV (78.1%), and hypertension (74.7%). Sixteen conditions had <50% agreement, including cancers and substance use disorders. Overlap for mental health conditions ranged from 47.4% for anxiety to 59.8% for depression. DISCUSSION: Agreement between the 2 sources varied substantially. Conditions requiring regular management in primary care settings may have a higher agreement than those diagnosed and treated in specialty care.
conclusionRelying on EHR encounter data to identify chronic conditions without reference to patient problem lists may under-capture conditions among CHC patients in the United States.
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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.