Development of Phenotyping Algorithms for the Identification of Organ Transplant Recipients: Cohort Study

Studies involving organ transplant recipients (OTRs) are often limited to the variables collected in the national Scientific Registry of Transplant Recipients database. Electronic health records contain additional variables that can augment this data source if OTRs can be identified accurately. The...

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Bibliographic Details
Published in:JMIR medical informatics Vol. 8; no. 12; p. e18001
Main Authors: Wheless, Lee, Baker, Laura, Edwards, LaVar, Anand, Nimay, Birdwell, Kelly, Hanlon, Allison, Chren, Mary-Margaret
Format: Journal Article
Language:English
Published: Canada JMIR Publications 10.12.2020
Subjects:
Algorithms
Blood & organ donations
Bone marrow
Classification
Codes
Cohort analysis
Documentation
Electronic health records
Laboratories
Lung transplants
Original Paper
Patients
Stem cells
Terminology
electronic health record
phenotyping
organ transplant recipients
ISSN:2291-9694, 2291-9694
Online Access:Get full text
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Summary:Studies involving organ transplant recipients (OTRs) are often limited to the variables collected in the national Scientific Registry of Transplant Recipients database. Electronic health records contain additional variables that can augment this data source if OTRs can be identified accurately. The aim of this study was to develop phenotyping algorithms to identify OTRs from electronic health records. We used Vanderbilt's deidentified version of its electronic health record database, which contains nearly 3 million subjects, to develop algorithms to identify OTRs. We identified all 19,817 individuals with at least one International Classification of Diseases (ICD) or Current Procedural Terminology (CPT) code for organ transplantation. We performed a chart review on 1350 randomly selected individuals to determine the transplant status. We constructed machine learning models to calculate positive predictive values and sensitivity for combinations of codes by using classification and regression trees, random forest, and extreme gradient boosting algorithms. Of the 1350 reviewed patient charts, 827 were organ transplant recipients while 511 had no record of a transplant, and 12 were equivocal. Most patients with only 1 or 2 transplant codes did not have a transplant. The most common reasons for being labeled a nontransplant patient were the lack of data (229/511, 44.8%) or the patient being evaluated for an organ transplant (174/511, 34.1%). All 3 machine learning algorithms identified OTRs with overall >90% positive predictive value and >88% sensitivity. Electronic health records linked to biobanks are increasingly used to conduct large-scale studies but have not been well-utilized in organ transplantation research. We present rigorously evaluated methods for phenotyping OTRs from electronic health records that will enable the use of the full spectrum of clinical data in transplant research. Using several different machine learning algorithms, we were able to identify transplant cases with high accuracy by using only ICD and CPT codes.
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ISSN:2291-9694
2291-9694
DOI:10.2196/18001