Ascertainment of Aspirin Exposure Using Structured and Unstructured Large-scale Electronic Health Record Data
Bibliographic Data
| ID | 9104408 |
|---|---|
| Authors | Ranier Bustamante (0000-0002-4987-7917, VA San Diego Healthcare System, corresponding author), Ashley Earles (VA San Diego Healthcare System, corresponding author), James D Murphy (0009-0008-1719-5111, University of California San Diego), Alex K Bryant (0000-0003-0194-8381, University of California San Diego), Olga V Patterson (0000-0002-8717-5975, VA Salt Lake City Health Care System), Andrew J Gawron (0000-0002-8968-6998, VA Salt Lake City Health Care System), Tonya Kaltenbach (0000-0002-0324-1542, San Francisco VA Medical Center), Mary A Whooley (0000-0002-5943-0078, San Francisco VA Medical Center), Deborah A Fisher (0000-0002-3823-3438, Durham VA Medical Center, corresponding author), Sameer D Saini (VA Ann Arbor Healthcare System), Samir Gupta (0000-0002-7307-6247, VA San Diego Healthcare System, corresponding author), Lin Liu (0000-0002-7202-3418, VA San Diego Healthcare System, corresponding author) |
| Year | 2019 |
| Volume | 57 |
| Issue | 10 |
| Pages | e60-e64 |
| Publication date | 2019-10-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001065 |
| PMID | 30807451 |
| OpenAlex | W2916621496 |
| Language | EN |
| References cited | 17 |
BACKGROUND: Aspirin impacts risk for important outcomes such as cancer, cardiovascular disease, and gastrointestinal bleeding. However, ascertaining exposure to medications available both by prescription and over-the-counter such as aspirin for research and quality improvement purposes is a challenge. OBJECTIVES: Develop and validate a strategy for ascertaining aspirin exposure, utilizing a combination of structured and unstructured data. RESEARCH DESIGN: This is a retrospective cohort study. SUBJECTS: In total, 1,869,439 Veterans who underwent usual care colonoscopy 1999-2014 within the Department of Veterans Affairs. MEASURES: Aspirin exposure and dose were obtained from an ascertainment strategy combining query of structured medication records available in electronic health record databases and unstructured data extracted from free-text progress notes. Prevalence of any aspirin exposure and dose-specific exposure were estimated. Positive predictive value and negative predictive value were used to assess strategy performance, using manual chart review as the reference standard. RESULTS: Our combined strategy for ascertaining aspirin exposure using structured and unstructured data reached a positive predictive value and negative predictive value of 99.2% and 97.5% for any exposure, and 92.6% and 98.3% for dose-specific exposure. Estimated prevalence of any aspirin exposure was 36.3% (95% confidence interval: 36.2%-36.4%) and dose-specific exposure was 35.4% (95% confidence interval: 35.3%-35.5%). CONCLUSIONS: A readily accessible approach utilizing a combination of structured medication records and query of unstructured data can be used to ascertain aspirin exposure when manual chart review is impractical
Aspirin · Cancer · Colonoscopy · Colorectal cancer · Confidence interval · Data mining · Medical prescription · Retrospective cohort study · Unstructured data · Veterans Affairs · Antiplatelet Therapy and Cardiovascular Diseases · Computer Science · Emergency Medicine · Inflammatory mediators and NSAID effects · Internal Medicine · Medicine · Pharmacovigilance and Adverse Drug Reactions
| Highly cited | No |
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