Evidence map›Paper›PMID 41035064›Full record

ArticleBMC research notes2025

Improving the accuracy and precision of disease identification when utilizing EHR data for research: the case for hepatocellular carcinoma.

Carrie R Wong, Yvonne N Flores, Analissa Avila, Lina Tieu, Catherine M Crespi, Folasade P May, Douglas S Bell, Beth Glenn, Roshan Bastani

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC research notes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Carrie R WongVatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, University of California, Los Angeles, USA. crwong@mednet.ucla.edu.ORCID http://orcid.org/0000-0002-2052-3701
Yvonne N FloresUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
Analissa AvilaUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
Lina TieuUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
Catherine M CrespiUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
Folasade P MayVatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, University of California, Los Angeles, USA.
Douglas S BellDivision of General Internal Medicine, Department of Medicine, University of California, Los Angeles, USA.
Beth GlennUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
Roshan BastaniUCLA Center for Cancer Prevention and Control and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
National Center for Advancing Translational Science of the National Institutes of Health - Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, and Clinical Translational Science Institute at the University of California, Los Angeles UL1TR001881NCATS NIH HHS UL1 TR001881
6 · The paper itself

Abstract

objectiveWe assessed the performance of International Classification of Diseases (ICD) codes to identify patients with hepatocellular carcinoma (HCC) in a large academic health system and determined whether employing an algorithm using a combination of ICD codes could deliver higher accuracy and precision than single ICD codes in identifying HCC cases using electronic health record (EHR) data.

resultsThe use of a single ICD code entry for HCC (ICD-9-CM 155.0 or ICD-10-CM C22.0) in our cohort of 1,007 established ambulatory care patients with potential HCC yielded 58% false positives (not true HCC cases) based on chart reviews. We developed an ICD code-based algorithm that prioritized positive predictive value (PPV), F-score, and accuracy to minimize false positives and negatives. Using manual chart reviews as the gold standard, the highest performing algorithm required at least 10 ICD code entries for HCC and the sum of ICD code entries for HCC to exceed the sum of ICD code entries for non-HCC malignancies. The algorithm demonstrated high performance (PPV 97.4%, F-score 0.92, accuracy 94%), which was internally validated (PPV 92.3%, F-score 0.90, accuracy 91%) using a separate sample of 285 cancer registry cases. Our findings support the need to assess the accuracy and precision of ICD codes before using EHR data to study HCC more broadly.

Indexed as

AlgorithmsCarcinoma, HepatocellularElectronic Health RecordsInternational Classification of DiseasesLiver NeoplasmsAgedFemaleHumansMaleMiddle AgedAccuracyAlgorithmChronic liver diseaseElectronic health recordElectronic medical recordHepatocellular carcinomaICD codeInternational Classification of DiseasesLiver cancerPrecision

Identifiers

PMID41035064
PMCPMC12487526

What OpenQuestion holds

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LicenceCC BY
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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.