Evidence map›Paper›PMID 36377765›Full record

ArticleAutism research : official journal of the International Society for Autism Research2023

A practical approach to identifying autistic adults within the electronic health record.

Beth A Malow, Olivia J Veatch, Xinnan Niu, Kasey A Fitzpatrick, Donald Hucks, Angie Maxwell-Horn, Lea K Davis

Abstract read
In one paragraph

Article in Autism research : official journal of the International Society for Autism Research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
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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

7 authors.

Beth A MalowSleep Disorders Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-1624-7636
Olivia J VeatchDepartment of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, Kansas, USA.
Xinnan NiuDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kasey A FitzpatrickSleep Disorders Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Donald HucksDivision of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Angie Maxwell-HornDivision of Developmental Medicine, Department of Pediatric, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Lea K DavisDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
Overall: Eunice Kennedy Shriver Intellectual and Developmental Disabilities Research Center at VanderbiltP50HD103537 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lea K Davis · 2020 to 2026
$10.3M
Elucidating the causes and consequences of sleep disturbances in children with rare genetic syndromesR21HD107535 · NICHD · UNIVERSITY OF KANSAS MEDICAL CENTER · PI BUTLER, MERLIN G, VEATCH, OLIVIA J · 2022 to 2023
$426k
Harnessing Electronic Health Records to Identify Participants and to Study Health Outcomes in Transition-Age Youth and Adults with Autism Spectrum DisorderK18MH122755 · NIMH · VANDERBILT UNIVERSITY MEDICAL CENTER · PI MALOW, BETH A · 2020 to 2021
$340k
NCATS NIH HHS UL1 TR002243NICHD NIH HHS P50 HD103537NICHD NIH HHS R21 HD107535NIMH NIH HHS K18 MH122755
6 · The paper itself

Abstract

The electronic health record (EHR) provides valuable data for understanding physical and mental health conditions in autism. We developed an approach to identify charts of autistic young adults, retrieved from our institution's de-identified EHR database. Clinical notes within two cohorts were identified. Cohort 1 charts had at least one International Classification of Diseases (ICD-CM) autism code. Cohort 2 charts had only autism key terms without ICD-CM codes, and at least four notes per chart. A natural language processing tool parsed medical charts to identify key terms associated with autism diagnoses and mapped them to Unified Medical Language System Concept Unique Identifiers (CUIs). Average scores were calculated for each set of charts based on captured CUIs. Chart review determined whether patients met criteria for autism using a classification rubric. In Cohort 1, of 418 patients, 361 were confirmed to have autism by chart review. Sensitivity was 0.99 and specificity was 0.68 with positive predictive value (PPV) of 0.97. Specificity improved to 0.81 (sensitivity was 0.95; PPV was 0.98) when the number of notes was limited to four or more per chart. In Cohort 2, 48 of 136 patients were confirmed to have autism by chart review. Sensitivity was 0.95, specificity was 0.73, and PPV was 0.70. Our approach, which included using key terms, identified autism charts with high sensitivity, even in the absence of ICD-CM codes. Relying on ICD-CM codes alone may result in inclusion of false positive cases and exclusion of true cases with autism.

Indexed as

Autism Spectrum DisorderAutistic DisorderAlgorithmsElectronic Health RecordsHumansPredictive Value of TestsYoung Adultadolescentsadultsco-morbid conditionsneurology

Identifiers

PMID36377765
PMCPMC9839634

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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.