期刊
JOURNAL OF BIOMEDICAL SEMANTICS
卷 6, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s13326-015-0010-8
关键词
Electronic Health Records; Phenotype; Health status indicators; Data mining; Outcome assessment (Health Care)
资金
- [R01 LM006910]
- [T15 LM00707]
Background: Electronic Health Records (EHRs) contain a wealth of information useful for studying clinical phenotype-genotype relationships. Severity is important for distinguishing among phenotypes; however other severity indices classify patient-level severity (e.g., mild vs. acute dermatitis) rather than phenotype-level severity (e.g., acne vs. myocardial infarction). Phenotype-level severity is independent of the individual patient's state and is relative to other phenotypes. Further, phenotype-level severity does not change based on the individual patient. For example, acne is mild at the phenotype-level and relative to other phenotypes. Therefore, a given patient may have a severe form of acne (this is the patient-level severity), but this does not effect its overall designation as a mild phenotype at the phenotype-level. Methods: We present a method for classifying severity at the phenotype-level that uses the Systemized Nomenclature of Medicine - Clinical Terms. Our method is called the Classification Approach for Extracting Severity Automatically from Electronic Health Records (CAESAR). CAESAR combines multiple severity measures - number of comorbidities, medications, procedures, cost, treatment time, and a proportional index term. CAESAR employs a random forest algorithm and these severity measures to discriminate between severe and mild phenotypes. Results: Using a random forest algorithm and these severity measures as input, CAESAR differentiates between severe and mild phenotypes (sensitivity = 91.67, specificity = 77.78) when compared to a manually evaluated reference standard (k = 0.716). Conclusions: CAESAR enables researchers to measure phenotype severity from EHRs to identify phenotypes that are important for comparative effectiveness research.
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