Browsing by Author "Johnson, Kevin B."

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    Data-driven automated classification algorithms for acute health conditions: applying PheNorm to COVID-19 disease
    (American Medical Informatics Association, 2024) Smith, Joshua C.; Williamson, Brian D.; Cronkite, David J.; Park, Daniel; Whitaker, Jill M.; McLemore, Michael F.; Osmanski, Joshua T.; Winter, Robert; Ramaprasan, Arvind; Kelley, Ann; Shea, Mary; Wittayanukorn, Saranrat; Stojanovic, Danijela; Zhao, Yueqin; Toh, Sengwee; Johnson, Kevin B.; Aronoff, David M.; Carrell, David S.; Medicine, School of Medicine
    Objectives: Automated phenotyping algorithms can reduce development time and operator dependence compared to manually developed algorithms. One such approach, PheNorm, has performed well for identifying chronic health conditions, but its performance for acute conditions is largely unknown. Herein, we implement and evaluate PheNorm applied to symptomatic COVID-19 disease to investigate its potential feasibility for rapid phenotyping of acute health conditions. Materials and methods: PheNorm is a general-purpose automated approach to creating computable phenotype algorithms based on natural language processing, machine learning, and (low cost) silver-standard training labels. We applied PheNorm to cohorts of potential COVID-19 patients from 2 institutions and used gold-standard manual chart review data to investigate the impact on performance of alternative feature engineering options and implementing externally trained models without local retraining. Results: Models at each institution achieved AUC, sensitivity, and positive predictive value of 0.853, 0.879, 0.851 and 0.804, 0.976, and 0.885, respectively, at quantiles of model-predicted risk that maximize F1. We report performance metrics for all combinations of silver labels, feature engineering options, and models trained internally versus externally. Discussion: Phenotyping algorithms developed using PheNorm performed well at both institutions. Performance varied with different silver-standard labels and feature engineering options. Models developed locally at one site also worked well when implemented externally at the other site. Conclusion: PheNorm models successfully identified an acute health condition, symptomatic COVID-19. The simplicity of the PheNorm approach allows it to be applied at multiple study sites with substantially reduced overhead compared to traditional approaches.
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    Use of Electronic Health Records to Support a Public Health Response to the COVID-19 Pandemic in the United States: A Perspective from Fifteen Academic Medical Centers
    (Oxford University Press, 2020-11-03) Madhavan, Subha; Bastarache, Lisa; Brown, Jeffrey S.; Dorr, David A.; Embi, Peter J.; Friedman, Charles P.; Johnson, Kevin B.; Moore, Jason H.; Kohane, Isaac S.; Payne, Philip R.O.; Tenenbaum, Jessica D.; Weiner, Mark G.; Wilcox, Adam B.; Ohno-Machado, Lucila; Butte, Atul J.; Medicine, School of Medicine
    Our goal is to summarize the collective experience of 15 organizations in dealing with uncoordinated efforts that result in unnecessary delays in understanding, predicting, preparing for, containing, and mitigating the COVID-19 pandemic in the US. Response efforts involve the collection and analysis of data corresponding to healthcare organizations, public health departments, socioeconomic indicators, as well as additional signals collected directly from individuals and communities. We focused on electronic health record (EHR) data, since EHRs can be leveraged and scaled to improve clinical care, research, and to inform public health decision-making. We outline the current challenges in the data ecosystem and the technology infrastructure that are relevant to COVID-19, as witnessed in our 15 institutions. The infrastructure includes registries and clinical data networks to support population-level analyses. We propose a specific set of strategic next steps to increase interoperability, overall organization, and efficiencies