scholarly journals How well can electronic health records from primary care identify Alzheimer’s disease cases?

2019 ◽  
Vol Volume 11 ◽  
pp. 509-518 ◽  
Author(s):  
Anna Ponjoan ◽  
Josep Garre-Olmo ◽  
Jordi Blanch ◽  
Ester Fages ◽  
Lia Alves-Cabratosa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

DISCOVERING SUBTYPES OF ALZHEIMER'S DISEASE USING ELECTRONIC HEALTH RECORDS

2019 ◽  
Vol 15 (7) ◽  
pp. P156
Author(s):  
Nonie Alexander ◽  
Kenan Direk ◽  
Daniel C. Alexander ◽  
Spiros Denaxas
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

scholarly journals Data‐driven discovery of probable Alzheimer's disease and related dementia subphenotypes using electronic health records

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Jie Xu ◽  
Fei Wang ◽  
Zhenxing Xu ◽  
Prakash Adekkanattu ◽  
Pascal Brandt ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Data Driven ◽  
Health Records ◽  
Electronic Health

scholarly journals P1-554: DISCOVERING SUBTYPES OF ALZHEIMER'S DISEASE USING ELECTRONIC HEALTH RECORDS

2019 ◽  
Vol 15 ◽  
pp. P485-P485
Author(s):  
Nonie Alexander ◽  
Kenan Direk ◽  
Daniel C. Alexander ◽  
Spiros Denaxas
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

scholarly journals How good are electronic health records and death certificates for identifying Alzheimer’s disease and related dementia?

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Karen Schliep ◽  
Shinyoung Ju ◽  
Michael Varner ◽  
Jim VanDerslice ◽  
Ken Smith
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Area Under The Curve ◽  
Death Certificates ◽  
Population Database ◽  
Health Records ◽  
Predictive Values ◽  
Dementia Prevalence ◽  
Electronic Health

IntroductionEffects of early life conditions on Alzheimer’s disease (AD) and related dementia (RD) risk have been hypothesized. However, prospective study is potentially cost prohibitive. Retrospective studies using routinely collected health records in large cohorts may be a feasible way to carry out such research, but diagnostic accuracy should be determined. Objectives and ApproachWe aim to determine accuracy of AD/RD diagnoses in electronic health records (EHR) (inpatient, ambulatory surgery, and Medicare) and death certificates (DC) compared to gold standard. The Cache County Study on Memory in Aging (CACHE, 1995–2008) enrolled 90% of the county’s residents age ≥ 65 years (N=5092). Over the course of 12 years/4 triennial waves of thorough dementia ascertainment, 942 persons (18.5%) were identified with dementia. Prevalence of AD or AD comorbid with other dementia (AD mixed) was 12.8% and for RD alone, 5.7%. We used the Utah Population Database, linking EMR/DCs (1995–2008) to CACHE participants (98% linkage).  ResultsThe prevalence of AD/AD mixed and RD in EHR/DCs was 12.2% and 35.8%. Among linked CACHE participants diagnosed with AD or AD mixed (n=628), 505 (80%) were captured by EHR/DCs as having some form of dementia (AD, AD mixed, or RD) with 301 (60%) correctly classified as having AD or AD mixed. Among those with RD (n=399), 275 (69%) were captured by EHR/DCs as having some form of dementia, with 163 (60%) correctly classified as having RD. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were 48%, 93%, 49%, 93%, and 0.70 for AD or AD mixed; and 67%, 67%, 15%, 96%, and 0.67 for RD. Overall dementia agreement between CACHE diagnoses and EHR/DCs was fair (Cohen's κ = 0.34). Conclusion/ImplicationsIn this will characterized cohort, routinely collected health record diagnoses of AD/AD mixed and RD have only fair correlation with carefully phenotyped diagnoses. Determining additional features of a person’s medical record that may be predictive of AD/RD via formal classification modeling is warranted.

scholarly journals Identifying and evaluating clinical subtypes of Alzheimer’s disease in care electronic health records using unsupervised machine learning

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nonie Alexander ◽  
Daniel C. Alexander ◽  
Frederik Barkhof ◽  
Spiros Denaxas
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Affinity Propagation ◽  
Class Analysis ◽  
Clustering Methods ◽  
Health Records ◽  
Electronic Health

Abstract Background Alzheimer’s disease (AD) is a highly heterogeneous disease with diverse trajectories and outcomes observed in clinical populations. Understanding this heterogeneity can enable better treatment, prognosis and disease management. Studies to date have mainly used imaging or cognition data and have been limited in terms of data breadth and sample size. Here we examine the clinical heterogeneity of Alzheimer's disease patients using electronic health records (EHR) to identify and characterise disease subgroups using multiple clustering methods, identifying clusters which are clinically actionable. Methods We identified AD patients in primary care EHR from the Clinical Practice Research Datalink (CPRD) using a previously validated rule-based phenotyping algorithm. We extracted and included a range of comorbidities, symptoms and demographic features as patient features. We evaluated four different clustering methods (k-means, kernel k-means, affinity propagation and latent class analysis) to cluster Alzheimer’s disease patients. We compared clusters on clinically relevant outcomes and evaluated each method using measures of cluster structure, stability, efficiency of outcome prediction and replicability in external data sets. Results We identified 7,913 AD patients, with a mean age of 82 and 66.2% female. We included 21 features in our analysis. We observed 5, 2, 5 and 6 clusters in k-means, kernel k-means, affinity propagation and latent class analysis respectively. K-means was found to produce the most consistent results based on four evaluative measures. We discovered a consistent cluster found in three of the four methods composed of predominantly female, younger disease onset (43% between ages 42–73) diagnosed with depression and anxiety, with a quicker rate of progression compared to the average across other clusters. Conclusion Each clustering approach produced substantially different clusters and K-Means performed the best out of the four methods based on the four evaluative criteria. However, the consistent appearance of one particular cluster across three of the four methods potentially suggests the presence of a distinct disease subtype that merits further exploration. Our study underlines the variability of the results obtained from different clustering approaches and the importance of systematically evaluating different approaches for identifying disease subtypes in complex EHR.

scholarly journals P1-270: MACHINE LEARNING PREDICTION OF FUTURE INCIDENCE OF ALZHEIMER'S DISEASE USING POPULATION-WIDE ELECTRONIC HEALTH RECORDS

2019 ◽  
Vol 15 ◽  
pp. P342-P343 ◽  
Author(s):  
Ji-Hwan Park ◽  
Han-Eol Cho ◽  
Jun Min Cha ◽  
Jong Hun Kim ◽  
Shinjae Yoo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

Preliminary results from the COPE study using primary-care electronic health records and environmental modelling to examine COPD exacerbations

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696749 ◽  
Author(s):  
Maimoona Hashmi ◽  
Mark Wright ◽  
Kirin Sultana ◽  
Benjamin Barratt ◽  
Lia Chatzidiakou ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Management ◽  
Practice Research ◽  
Chronic Obstructive ◽  
Clinical Practice Research Datalink ◽  
Health Records ◽  
Preliminary Results ◽  
Copd Exacerbations ◽  
Electronic Health

BackgroundChronic Obstructive Airway Disease (COPD) is marked by often severely debilitating exacerbations. Efficient patient-centric research approaches are needed to better inform health management primary-care.AimThe ‘COPE study’ aims to develop a method of predicting COPD exacerbations utilising personal air quality sensors, environmental exposure modelling and electronic health records through the recruitment of patients from consenting GPs contributing to the Clinical Practice Research Datalink (CPRD).MethodThe study made use of Electronic Healthcare Records (EHR) from CPRD, an anonymised GP records database to screen and locate patients within GP practices in Central London. Personal air monitors were used to capture data on individual activities and environmental exposures. Output from the monitors were then linked with the EHR data to obtain information on COPD management, severity, comorbidities and exacerbations. Symptom changes not equating to full exacerbations were captured on diary cards. Linear regression was used to investigate the relationship between subject peak flow, symptoms, exacerbation events and exposure data.ResultsPreliminary results on the first 80 patients who have completed the study indicate variable susceptibility to environmental stressors in COPD patients. Some individuals appear highly susceptible to environmental stress and others appear to have unrelated triggers.ConclusionRecruiting patients through EHR for a study is feasible and allows easy collection of data for long term follow up. Portable environmental sensors could now be used to develop personalised models to predict risk of COPD exacerbations in susceptible individuals. Identification of direct links between participant health and activities would allow improved health management thus cost savings.

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