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Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia
Deborah E Barnes1,2,3, Jing Zhou4, Rod L Walker4
1Department of Psychiatry, University of California, San Francisco, San Francisco, California.
Journal of the American Geriatrics Society
|October 16, 2019
Summary
Early dementia recognition improves patient care. A new electronic health record (EHR) tool, eRADAR, accurately identifies patients with unrecognized dementia using existing data, aiding earlier diagnosis and management.
Area of Science:
- Gerontology
- Medical Informatics
- Neurology
Background:
- Early dementia recognition is crucial for timely care and improved patient outcomes.
- A significant proportion of dementia cases remain undiagnosed, delaying necessary interventions.
- Electronic Health Records (EHRs) offer a potential data source for identifying at-risk individuals.
Purpose of the Study:
- To develop and validate an EHR-based tool, the EHR Risk of Alzheimer's and Dementia Assessment Rule (eRADAR), for detecting patients with unrecognized dementia.
- To improve the early identification of dementia through leveraging existing healthcare data.
Main Methods:
- A retrospective cohort study was conducted using data from Kaiser Permanente Washington (KPWA).
- The study included 16,665 visits from 4,330 participants in the Adult Changes in Thought (ACT) study, with data split into development (70%) and validation (30%) sets.
- EHR predictors such as demographics, diagnoses, vital signs, healthcare utilization, and medications from the prior two years were analyzed.
Main Results:
- Nearly half (49%) of incident dementia cases identified in the ACT study were not documented in the KPWA EHR.
- A 31-predictor model (eRADAR) incorporating symptoms, healthcare utilization, and risk factors demonstrated good discrimination in both development (C=0.78) and validation (C=0.81) samples.
- Flagging the top 5% of patients by eRADAR score for evaluation could identify dementia in 1 in 6 individuals.
Conclusions:
- The eRADAR tool effectively utilizes existing EHR data to accurately detect patients who may have unrecognized dementia.
- This tool has the potential to significantly improve the early diagnosis and management of dementia.
- Further implementation of eRADAR could enhance dementia care pathways and patient outcomes.
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