ArticlePloS one2022
Accuracy of the electronic health record's problem list in describing multimorbidity in patients with heart failure in the emergency department.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Trial
- Attitudes Toward Deprescribing Among Older Adults Seeking Care in the Emergency Department.Journal of the American College of Emergency Physicians open · 2026Article
- Current state of electronic problems lists in primary care: a rapid scoping review.Family practice · 2026Article
- Characterizing emergency clinician engagement with social drivers of health data among patients with opioid use disorder.medRxiv : the preprint server for health sciences · 2025Article
- Appropriateness of Antiplatelets and Anticoagulants Among Older Adults Experiencing Falls.Journal of the American Geriatrics Society · 2025Article
- Article
- Using electronic health records to understand multimorbidity in older people: a scoping review.European geriatric medicine · 2025Article
- A scoping review of digital health technologies in multimorbidity management: mechanisms, outcomes, challenges, and strategies.BMC health services research · 2025Article
- Emergency Department Use of Heart Failure-Exacerbating Medications in Patients with Chronic Heart Failure.Drug safety · 2024Observational
- Prevalence of fall risk-increasing drugs in older adults presenting with falls to the emergency department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
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Authors and funding
9 authors.
Funding
Abstract
Patients with heart failure (HF) often suffer from multimorbidity. Rapid assessment of multimorbidity is important for minimizing the risk of harmful drug-disease and drug-drug interactions. We assessed the accuracy of using the electronic health record (EHR) problem list to identify comorbid conditions among patients with chronic HF in the emergency department (ED). A retrospective chart review study was performed on a random sample of 200 patients age ≥65 years with a diagnosis of HF presenting to an academic ED in 2019. We assessed participant chronic conditions using: (1) structured chart review (gold standard) and (2) an EHR-based algorithm using the problem list. Chronic conditions were classified into 37 disease domains using the Agency for Healthcare Research Quality's Elixhauser Comorbidity Software. For each disease domain, we report the sensitivity, specificity, positive predictive value, and negative predictive of using an EHR-based algorithm. We calculated the intra-class correlation coefficient (ICC) to assess overall agreement on Elixhauser domain count between chart review and problem list. Patients with HF had a mean of 5.4 chronic conditions (SD 2.1) in the chart review and a mean of 4.1 chronic conditions (SD 2.1) in the EHR-based problem list. The five most prevalent domains were uncomplicated hypertension (90%), obesity (42%), chronic pulmonary disease (38%), deficiency anemias (33%), and diabetes with chronic complications (30.5%). The positive predictive value and negative predictive value of using the EHR-based problem list was greater than 90% for 24/37 and 32/37 disease domains, respectively. The EHR-based problem list correctly identified 3.7 domains per patient and misclassified 2.0 domains per patient. Overall, the ICC in comparing Elixhauser domain count was 0.77 (95% CI: 0.71-0.82). The EHR-based problem list captures multimorbidity with moderate-to-good accuracy in patient with HF in the ED.
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