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Retrospective application of algorithms to improve identification of pregnancy outcomes from the electronic health
Kajal Angras1, Victoria E Boyd2, Celia Gray3
1Women's Health Service Line, Division of Maternal-Fetal Medicine, Geisinger, 100N. Academy Avenue, Danville, PA, 17822, USA. kajalangras@gmail.com.
Objective:
To improve upon the accuracy of ICD codes for identifying maternal and neonatal outcomes by developing algorithms that incorporate readily available EHR data.
Study Design:
Algorithms were developed for gestational hypertension (GHTN), pre-eclampsia (PreE), gestational diabetes mellitus (GDM) and were compared to ICD codes and chart review. Accuracy and sensitivity analyses were calculated with their respective 95% confidence limits for each of the comparisons between algorithms, ICD codes alone, and chart review.
Results:
Sensitivity of GHTN ICD codes was 8.1% vs. 83.8% for the algorithm when compared to chart review. In comparison to chart review, sensitivity of ICD codes for PreE was 7.5% vs. 71.4% for the algorithm. GDM had similar sensitivity rates for both ICD codes and the algorithm.
Conclusion:
Application of algorithms, validated by chart review, enhanced capture of several outcomes. Algorithms should be obligatory adjunct tools to the ICD codes for identification of outcomes of interest.
