Researchers developed and validated the first electronic health record (EHR) algorithm that incorporates laboratory values and medications with the systemic lupus erythematosus (SLE) Internal Classification of Diseases, Ninth Revision (ICD-9) code to accurately identify patients with SLE, according to a recent study. They used Vanderbilt's Synthetic Derivative, a de-identified version of the EHR, with 2.5 million subjects, selecting all individuals with at least 1 SLE ICD-9 code, yielding 5,959 individuals. In order to create a training set, 200 subjects were randomly selected for chart review. A subject was defined as a case if diagnosed with SLE by a rheumatologist, nephrologist, or dermatologist. They found:
- The algorithm with the highest positive predictive values at 95% in the training set and 91% in the validation set was 3 or more counts of the SLE ICD-9 code, antinuclear antibody-positive, and ever use of both disease-modifying antirheumatic drugs and steroids, while excluding individuals with systemic sclerosis and dermatomyositis ICD-9 codes.
Barnado A, Casey C, Carroll RJ, Wheless L, Denny JC, Crofford LJ. Developing electronic health record algorithms that accurately identify patients with systemic lupus erythematosus. [Published online ahead of print April 10, 2017]. Arthritis Care Res. doi:10.1002/acr.22989.
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