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Identification of Axial Spondyloarthritis Patients in a Large Dataset: The Development and Validation of Novel Methods
- Source :
- The Journal of Rheumatology. 47:42-49
- Publication Year :
- 2019
- Publisher :
- The Journal of Rheumatology, 2019.
-
Abstract
- Objective.Observational axial spondyloarthritis (axSpA) research in large datasets has been limited by a lack of adequate methods for identifying patients with axSpA, because there are no billing codes in the United States for most subtypes of axSpA. The objective of this study was to develop methods to accurately identify patients with axSpA in a large dataset.Methods.The study population included 600 chart-reviewed veterans, with and without axSpA, in the Veterans Health Administration between January 1, 2005, and June 30, 2015. AxSpA identification algorithms were developed with variables anticipated by clinical experts to be predictive of an axSpA diagnosis [demographics, billing codes, healthcare use, medications, laboratory results, and natural language processing (NLP) for key SpA features]. Random Forest and 5-fold cross validation were used for algorithm development and testing in the training subset (n = 451). The algorithms were additionally tested in an independent testing subset (n = 149).Results.Three algorithms were developed: Full algorithm, High Feasibility algorithm, and Spond NLP algorithm. In the testing subset, the areas under the curve with the receiver-operating characteristic analysis were 0.96, 0.94, and 0.86, for the Full algorithm, High Feasibility algorithm, and Spond NLP algorithm, respectively. Algorithm sensitivities ranged from 85.0% to 95.0%, specificities from 78.0% to 93.6%, and accuracies from 82.6% to 91.3%.Conclusion.Novel axSpA identification algorithms performed well in classifying patients with axSpA. These algorithms offer a range of performance and feasibility attributes that may be appropriate for a broad array of axSpA studies. Additional research is required to validate the algorithms in other cohorts.
- Subjects :
- Adult
Male
Healthcare use
Immunology
Datasets as Topic
Blood Sedimentation
Comorbidity
Machine learning
computer.software_genre
Anti-Citrullinated Protein Antibodies
Cross-validation
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Rheumatology
Humans
Immunology and Allergy
Medicine
Spondylitis, Ankylosing
030212 general & internal medicine
Axial spondyloarthritis
HLA-B27 Antigen
Aged
030203 arthritis & rheumatology
Biological Products
business.industry
Middle Aged
Laboratory results
Additional research
Random forest
Identification (information)
C-Reactive Protein
ROC Curve
Antirheumatic Agents
Area Under Curve
Female
Observational study
Artificial intelligence
business
computer
Algorithms
Subjects
Details
- ISSN :
- 14992752 and 0315162X
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- The Journal of Rheumatology
- Accession number :
- edsair.doi.dedup.....9eeba6b446e5ff7d98447e2701640633
- Full Text :
- https://doi.org/10.3899/jrheum.181005