scholarly journals Improvement in Cardiovascular Risk Prediction with Electronic Health Records

2016 ◽  
Vol 9 (3) ◽  
pp. 214-222 ◽  
Author(s):  
Mindy M. Pike ◽  
Paul A. Decker ◽  
Nicholas B. Larson ◽  
Jennifer L. St. Sauver ◽  
Paul Y. Takahashi ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Electronic Health Records ◽  
Risk Prediction ◽  
Health Records ◽  
Cardiovascular Risk Prediction ◽  
Electronic Health

scholarly journals Rationale, design and population description of the CREDENCE study: cardiovascular risk equations for diabetes patients from New Zealand and Chinese electronic health records

2021 ◽  
Author(s):  
Jingyuan Liang ◽  
Romana Pylypchuk ◽  
Xun Tang ◽  
Peng Shen ◽  
Xiaofei Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
New Zealand ◽  
Electronic Health Records ◽  
Developing Country ◽  
Risk Prediction ◽  
Health Records ◽  
Cardiovascular Risk Prediction ◽  
Electronic Health

AbstractThe cardiovascular risk equations for diabetes patients from New Zealand and Chinese electronic health records (CREDENCE) study is a unique prospectively designed investigation of cardiovascular risk in two large contemporary cohorts of people with type 2 diabetes from New Zealand (NZ) and China. The study was designed to derive equivalent cardiovascular risk prediction equations in a developed and a developing country, using the same epidemiological and statistical methodology. Two similar cohorts of people with type 2 diabetes were identified from large general population studies in China and New Zealand, which had been generated from longitudinal electronic health record systems. The CREDENCE study aims to determine whether cardiovascular risk prediction equations derived in patients with type 2 diabetes in a developed country are applicable in a developing country, and vice versa, by deriving and validating equivalent diabetes-specific cardiovascular risk prediction models from the two countries. Baseline data in CREDENCE was collected from October 2004 in New Zealand and from January 2010 in China. In the first stage of CREDENCE, a total of 93,207 patients (46,649 from NZ and 46,558 from China) were followed until December 31st 2018. Median follow-up was 7.0 years (New Zealand) and 5.7 years (China). There were 5926 (7.7% fatal) CVD events in the New Zealand cohort and 3650 (8.8% fatal) in the Chinese cohort. The research results have implications for policy makers, clinicians and the public and will facilitate personalised management of cardiovascular risk in people with type 2 diabetes worldwide.

The process of sourcing and preparing electronic health records data to implement a machine-learning algorithm for early identification of maternal cardiovascular risk (Preprint)

2021 ◽  
Author(s):  
Nawar Shara ◽  
Kelley M. Anderson ◽  
Noor Falah ◽  
Maryam F. Ahmad ◽  
Darya Tavazoei ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cardiovascular Risk ◽  
Electronic Health Records ◽  
Patient Care ◽  
Early Identification ◽  
Health Data ◽  
Patient Specific ◽  
Patient Records ◽  
Health Records ◽  
Electronic Health

BACKGROUND Healthcare data are fragmenting as patients seek care from diverse sources. Consequently, patient care is negatively impacted by disparate health records. Machine learning (ML) offers a disruptive force in its ability to inform and improve patient care and outcomes [6]. However, the differences that exist in each individual’s health records, combined with the lack of health-data standards, in addition to systemic issues that render the data unreliable and that fail to create a single view of each patient, create challenges for ML. While these problems exist throughout healthcare, they are especially prevalent within maternal health, and exacerbate the maternal morbidity and mortality (MMM) crisis in the United States. OBJECTIVE Maternal patient records were extracted from the electronic health records (EHRs) of a large tertiary healthcare system and made into patient-specific, complete datasets through a systematic method so that a machine-learning-based (ML-based) risk-assessment algorithm could effectively identify maternal cardiovascular risk prior to evidence of diagnosis or intervention within the patient’s record. METHODS We outline the effort that was required to define the specifications of the computational systems, the dataset, and access to relevant systems, while ensuring data security, privacy laws, and policies were met. Data acquisition included the concatenation, anonymization, and normalization of health data across multiple EHRs in preparation for its use by a proprietary risk-stratification algorithm designed to establish patient-specific baselines to identify and establish cardiovascular risk based on deviations from the patient’s baselines to inform early interventions. RESULTS Patient records can be made actionable for the goal of effectively employing machine learning (ML), specifically to identify cardiovascular risk in pregnant patients. CONCLUSIONS Upon acquiring data, including the concatenation, anonymization, and normalization of said data across multiple EHRs, the use of a machine-learning-based (ML-based) tool can provide early identification of cardiovascular risk in pregnant patients. CLINICALTRIAL N/A

scholarly journals A comparison of risk prediction methods using repeated observations: an application to electronic health records for hemodialysis

2017 ◽  
Vol 36 (17) ◽  
pp. 2750-2763 ◽  
Author(s):  
Benjamin A. Goldstein ◽  
Gina Maria Pomann ◽  
Wolfgang C. Winkelmayer ◽  
Michael J. Pencina
Keyword(s):  
Electronic Health Records ◽  
Risk Prediction ◽  
Prediction Methods ◽  
Health Records ◽  
Repeated Observations ◽  
Electronic Health

scholarly journals Opportunities and challenges in developing risk prediction models with electronic health records data: a systematic review

2016 ◽  
Vol 24 (1) ◽  
pp. 198-208 ◽  
Author(s):  
Benjamin A Goldstein ◽  
Ann Marie Navar ◽  
Michael J Pencina ◽  
John P A Ioannidis
Keyword(s):  
Systematic Review ◽  
Electronic Health Records ◽  
Risk Prediction ◽  
Model Building ◽  
Prediction Models ◽  
Clinical Prediction ◽  
Health Records ◽  
Clinical Risk ◽  
Electronic Health ◽  
And Performance

Objective: Electronic health records (EHRs) are an increasingly common data source for clinical risk prediction, presenting both unique analytic opportunities and challenges. We sought to evaluate the current state of EHR based risk prediction modeling through a systematic review of clinical prediction studies using EHR data. Methods: We searched PubMed for articles that reported on the use of an EHR to develop a risk prediction model from 2009 to 2014. Articles were extracted by two reviewers, and we abstracted information on study design, use of EHR data, model building, and performance from each publication and supplementary documentation. Results: We identified 107 articles from 15 different countries. Studies were generally very large (median sample size = 26 100) and utilized a diverse array of predictors. Most used validation techniques (n = 94 of 107) and reported model coefficients for reproducibility (n = 83). However, studies did not fully leverage the breadth of EHR data, as they uncommonly used longitudinal information (n = 37) and employed relatively few predictor variables (median = 27 variables). Less than half of the studies were multicenter (n = 50) and only 26 performed validation across sites. Many studies did not fully address biases of EHR data such as missing data or loss to follow-up. Average c-statistics for different outcomes were: mortality (0.84), clinical prediction (0.83), hospitalization (0.71), and service utilization (0.71). Conclusions: EHR data present both opportunities and challenges for clinical risk prediction. There is room for improvement in designing such studies.

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