Discovering hidden knowledge through auditing clinical diagnostic knowledge bases

Lenert, Matthew C.; Walsh, Colin G.; Miller, Randolph A.

doi:10.1016/j.jbi.2018.06.014

Cited by 5 publications

(1 citation statement)

References 32 publications

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“…There are many works on identifying similar concepts, including lexical, ontological and data-driven approaches [60][61][62] to can be leveraged to accomplish this task. Given complexity of the task, an appropriate method should be able to identify relevant but not necessarily semantically similar concept, concepts from different domains (such as laboratory tests relevant to a given disease) and clinically meaningful concept pairs (such as diagnosis-differential diagnosis pairs [63]).…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation of a scalable alternative to chart review for phenotype case adjudication using standardized structured data from electronic health records

Ostropolets

Hripcsak

Husain

et al. 2022

Preprint

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Objective Chart review as the current gold standard for phenotype evaluation cannot support observational research at scale. It is expensive, time-consuming, and variable. We aimed to evaluate the ability of structured data to support efficient patient status ascertainment and develop a standardized and scalable alternative to chart review. Methods We developed Knowledge-Enhanced Electronic Patient Profile Review system (KEEPER) that extracts the patient structured data elements relevant to a given phenotype and presents them in a standardized fashion that follows clinical reasoning principles. We evaluated its performance compared to manual chart review for four conditions (diabetes type I, acute appendicitis, end stage renal disease and chronic obstructive lung disease) using randomized two-period, two-sequence crossover design. Inter-method agreement, inter-rater agreement, accuracy, and review duration were measured. Results Ascertaining patient status with KEEPER was twice as fast compared to manual chart review. 88.1% of the patients were classified concordantly using full chart and KEEPER, but agreement varied depending on the condition. Two clinicians agreed in classification of patient status in 91.2% of the cases when using KEEPER compared to 76.3% when using full chart. Patient classification aligned with the gold standard in 88.1% and 86.9% of the cases respectively. Conclusion This proof-of-concept study demonstrated that structured data can be used for efficient patient ascertainment if are limited to only relevant subset and organized according to the clinical reasoning principles. A system that implements these principles can achieve similar accuracy and higher inter-rater reliability compared to chart review at a fraction of time.

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Section: Discussionmentioning

confidence: 99%

Development and evaluation of a scalable alternative to chart review for phenotype case adjudication using standardized structured data from electronic health records

Ostropolets

Hripcsak

Husain

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Learning an expandable EMR-based medical knowledge network to enhance clinical diagnosis

Xie

Jiang

Wang³

et al. 2020

Artificial Intelligence in Medicine

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The “Electronic Pediatrician (EPed®)” – A clinically tested prototype software for computer-assisted pathophysiologic diagnosis and treatment of ill children

Drăgoi

Nemes

2023

International Journal of Medical Informatics

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Discovering hidden knowledge through auditing clinical diagnostic knowledge bases

Abstract: Data mining can provide an efficient supplement to ensuring the completeness of finding-finding interdependencies in diagnostic knowledge bases. Authors' findings should be applicable to other diagnostic systems that record finding frequencies within diseases (e.g., DXplain, ISABEL).

Cited by 5 publications

References 32 publications

Development and evaluation of a scalable alternative to chart review for phenotype case adjudication using standardized structured data from electronic health records

Development and evaluation of a scalable alternative to chart review for phenotype case adjudication using standardized structured data from electronic health records

Learning an expandable EMR-based medical knowledge network to enhance clinical diagnosis

The “Electronic Pediatrician (EPed®)” – A clinically tested prototype software for computer-assisted pathophysiologic diagnosis and treatment of ill children

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