Derivation and validation of a search algorithm to retrospectively identify CRRT initiation in the ECMO patients

Guru, Pramod; Singh, Thakar; Passe, Melissa; Kashani, Kianoush; Schears, Gregory J.; Kashyap, Rahul

doi:10.4338/aci-2015-12-ra-0183

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…The results of this study are in line with other published studies emphasizing the bene t of electronic search strategies in big dataset extraction. [29,40] Strengths: This method of electronic data extraction by automated algorithm through institutional software connected to EHR is cost-effective, fast, and accurate compared to manual chart review. The total time frame for the physician researcher JS to conduct manual chart reviews of each set of 100 patients was about 15 hours.…”

Section: Discussionmentioning

confidence: 99%

“…The adoption of electronic health records (EHR) in place of traditional paper charts has provided unprecedented amounts of information (Big data) that allows researchers to evaluate larger cohorts of patients than traditional research approaches. [28,29] Harnessing the potential of the EHR and the vast amounts of data within is challenging but developing and applying automated search strategies is a helpful approach. By using these tools to identify when an interpreter is utilized we can support quality improvement initiatives, enhance clinical practice, and improve our research accuracy and e ciency.…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

Soleimani

Márquez

Weister

et al. 2020

Preprint

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Background Evidence exists that disparities occur for patients with Limited English Proficiency (LEP) that impact the quality of medical services, outcomes, and patient satisfaction. Using interpreter services can reduce these negative impacts; therefore optimizing our understanding of interpreter use during patient care is important. Manual chart review is time-consuming. The objective of this study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services during their hospitalization. Methods We identified all adults who were admitted to the hospital who had at least one Intensive Care Units (ICU) admission during the hospital stay across the Mayo Clinic Enterprise between January 1, 2015, and June 30, 2020. Three random subsets of 100 patients were extracted from 60,268 patients admitted to an ICU to develop the search strategy algorithm. A physician reviewer conducted the gold standard manual chart review and these results were compared with the search strategy algorithm each time it was refined. Iterative modification of the search strategy was performed and sensitivity and specificity were calculated by comparing the results to the reference standard for both derivation cohorts and the final validation cohort. Any uncertainties were resolved by a second physician researcher. Results The first search strategy resulted in a specificity of 95.7% and a sensitivity of 93.5%. The second revised search strategy achieved a specificity of 96.7% and a sensitivity of 92.3%. The final version of the search strategy was applied to the validation subset and specificity and sensitivity were 92.6% and 100% respectively. Conclusion We successfully derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Developing a search strategy algorithm with a high sensitivity can reduce the time required to abstract data from the medical record compared to manual chart review. This can be used to examine and understand patient needs for research and quality improvement initiatives.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

Soleimani

Márquez

Weister

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Extracorporeal membrane oxygenation (ECMO), as a mechanical circulatory support system, is utilized as a treatment for cardiovascular or respiratory failure [1,2,3]. There are two main types of ECMO, including venovenous (VV)-ECMO for patients with isolated respiratory failure and venoarterial (VA)-ECMO for combined severe cardiac and respiratory failure [4].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Impact of Acute Kidney Injury in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis

Thongprayoon

Cheungpasitporn

Lertjitbanjong

et al. 2019

JCM

Self Cite

105

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Background: Although acute kidney injury (AKI) is a frequent complication in patients receiving extracorporeal membrane oxygenation (ECMO), the incidence and impact of AKI on mortality among patients on ECMO remain unclear. We conducted this systematic review to summarize the incidence and impact of AKI on mortality risk among adult patients on ECMO. Methods: A literature search was performed using EMBASE, Ovid MEDLINE, and Cochrane Databases from inception until March 2019 to identify studies assessing the incidence of AKI (using a standard AKI definition), severe AKI requiring renal replacement therapy (RRT), and the impact of AKI among adult patients on ECMO. Effect estimates from the individual studies were obtained and combined utilizing random-effects, generic inverse variance method of DerSimonian-Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018103527). Results: 41 cohort studies with a total of 10,282 adult patients receiving ECMO were enrolled. Overall, the pooled estimated incidence of AKI and severe AKI requiring RRT were 62.8% (95%CI: 52.1%–72.4%) and 44.9% (95%CI: 40.8%–49.0%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of AKI (p = 0.67) or AKI requiring RRT (p = 0.83). The pooled odds ratio (OR) of hospital mortality among patients receiving ECMO with AKI on RRT was 3.73 (95% CI, 2.87–4.85). When the analysis was limited to studies with confounder-adjusted analysis, increased hospital mortality remained significant among patients receiving ECMO with AKI requiring RRT with pooled OR of 3.32 (95% CI, 2.21–4.99). There was no publication bias as evaluated by the funnel plot and Egger’s regression asymmetry test with p = 0.62 and p = 0.17 for the incidence of AKI and severe AKI requiring RRT, respectively. Conclusion: Among patients receiving ECMO, the incidence rates of AKI and severe AKI requiring RRT are high, which has not changed over time. Patients who develop AKI requiring RRT while on ECMO carry 3.7-fold higher hospital mortality.

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“…In this study, we demonstrated an automated search strategy for ARDS that could effectively and accurately identify patients based on the accepted clinical definition (i.e., Berlin definition, among ICU patients). Several previously automated search strategies have been described in the literature ( 13 – 15 , 21 , 22 ); however, to date, the Berlin definition has not been used as a digital signature of ARDS patients.…”

Section: Discussionmentioning

confidence: 99%

Derivation and Validation of an Automated Search Strategy to Retrospectively Identify Acute Respiratory Distress Patients Per Berlin Definition

et al. 2021

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Purpose: Acute respiratory distress syndrome (ARDS) is common in critically ill patients and linked with serious consequences. A manual chart review for ARDS diagnosis could be laborious and time-consuming. We developed an automated search strategy to retrospectively identify ARDS patients using the Berlin definition to allow for timely and accurate ARDS detection.Methods: The automated search strategy was created through sequential steps, with keywords applied to an institutional electronic medical records (EMRs) database. We included all adult patients admitted to the intensive care unit (ICU) at the Mayo Clinic (Rochester, MN) from January 1, 2009 to December 31, 2017. We selected 100 patients at random to be divided into two derivation cohorts and identified 50 patients at random for the validation cohort. The sensitivity and specificity of the automated search strategy were compared with a manual medical record review (gold standard) for data extraction of ARDS patients per Berlin definition.Results: On the first derivation cohort, the automated search strategy achieved a sensitivity of 91.3%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 93.1%. On the second derivation cohort, it reached the sensitivity of 90.9%, specificity of 100%, PPV of 100%, and NPV of 93.3%. The strategy performance in the validation cohort had a sensitivity of 94.4%, specificity of 96.9%, PPV of 94.4%, and NPV of 96.9%.Conclusions: This automated search strategy for ARDS with the Berlin definition is reliable and accurate, and can serve as an efficient alternative to time-consuming manual data review.

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Derivation and validation of a search algorithm to retrospectively identify CRRT initiation in the ECMO patients

Abstract: The use of an electronic search strategy resulted in determining an accurate CRRT initiation time among ECMO patients.

Cited by 9 publications

References 13 publications

WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

Incidence and Impact of Acute Kidney Injury in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis

Derivation and Validation of an Automated Search Strategy to Retrospectively Identify Acute Respiratory Distress Patients Per Berlin Definition

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