Computable phENotype To Identify Pulmonary Embolism in chilDrEn (CENTIPEDE)
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Abstract
Study to test the classification accuracy of an algorithm that has been previously validated in adult pulmonary embolism (PE) patients (“ASPECT”). The algorithm was used to identify a pediatric PE cohort from EHR and evaluate the accuracy of diagnostic and treatment code combinations using EHR data to diagnose pediatric PE at a single center, the Children’s Hospital of Philadelphia.
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The rate of pediatric pulmonary embolism (PPE), the most serious and potentially deadly form of venous thromboembolism, has increased by 200% over the last decade. But it remains rare at individual centers and consequently is challenging to study. Currently, the management of PPE is empiric and not derived from scientific evidence. Electronic health records (EHR) are a rich source of clinical information that can be used to study rare diseases provided a disease cohort is accurately identified. Previous studies in adults have revealed that using appropriate combinations of diagnostic and treatment codes leads to accurate identification of a PE cohort from EHR.
The purpose of this study is to identify the best combination of diagnostic and treatment codes using EHR data that can accurately diagnose PPE at a single center.
Study Aims
- Test the classification accuracy of an algorithm (ASPECT) that has been previously validated in adult PE patients to identify pediatric PE cohort from EHR.
- Evaluate the accuracy of other combinations of diagnostic and treatment codes using EHR data to diagnose pediatric PE at a single center (CHOP).
Study Design
A retrospective cohort study using structured data and chart reviews to develop a computable phenotype.
Cohort Description
Patients who meet the inclusion and exclusion criteria of the ASPECT computational phenotype from January 2012 to December 2022. ASPECT criteria include an anticoagulant prescription associated with an inpatient or emergency visit at age 21 or younger; a pulmonary embolism diagnosis code associated with an inpatient or emergency visit at age 21 or younger; a diagnostic imaging study performed during or two fewer days before the visit; an anticoagulant dispensed or prescribed during the visit; and excludes patients with an anticoagulant dispensed or prescribed between 7 and 365 days before the visit.
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