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Development of a Computable Phenotype for Venous Thrombosis Present on Admission: The Medical Inpatient Thrombosis and Hemostasis (MITH) Study

R. Thomas1, I. Koh1, K. Wilkinson1, A. Li2, N. Roetker3, N. Smith4, A. Repp1, C. Holmes1, T. Plante1, M. Cushman1, N. Zakai1

1University of Vermont Medical Center, Burlington, United States, 2Baylor College of Medicine, Houston, United States, 3Chronic Disease Research Group, Minneapolis, United States, 4University of Washington, Seattle, United States

Abstract Number: PB1200

Meeting: ISTH 2021 Congress

Theme: Venous Thromboembolism » VTE Epidemiology

Background: Venous thromboembolisms (VTEs) are largely preventable and currently there is not a computable phenotype to quickly and accurately identify VTE using electronic health record (EHR) data. Computable phenotypes make it possible to rapidly identify a condition without manual chart abstraction.

Aims: We sought to develop and validate an accurate and reproducible computable phenotype for newly diagnosed VTE that is present at admission (POA). Our goal is to differentiate VTE POA from VTE that is hospital acquired, previously diagnosed/treated, or miscoded.

Methods: We captured all admissions to the medical services between 2010-19 at the University of Vermont Medical Center. A computable phenotype for VTE was developed using International Classification of Diseases (ICD) 9 or 10 discharge codes with the POA billing flag, current procedure terminology (CPT) codes for VTE-directed imaging studies, and anticoagulant medication administration. The algorithm that was created was compared with the gold standard for VTE POA – physician chart abstraction. 120 charts were abstracted from five different categories and the sensitivity and specificity of the computable phenotype vs. gold standard was assessed using survey weighting methodology.

Results: For the 120 charts that were abstracted for the computable phenotype, 71 charts were marked as POA VTE by the computable phenotype and 63 of these were confirmed as POA VTE with manual abstraction. Using survey weighting methodology to recreate the source population, the VTE case definition had a specificity of 95.9% and a sensitivity of 99.6% (Table).

Weighted POA VTE data comparing physician chart abstraction and the computable phenotype

Conclusions: We developed a computable phenotype to identify POA VTE with excellent sensitivity and specificity. This can be used to further define risk factors for VTE using EHR data and to differentiate VTE POA from hospital-acquired VTE.

To cite this abstract in AMA style:

Thomas R, Koh I, Wilkinson K, Li A, Roetker N, Smith N, Repp A, Holmes C, Plante T, Cushman M, Zakai N. Development of a Computable Phenotype for Venous Thrombosis Present on Admission: The Medical Inpatient Thrombosis and Hemostasis (MITH) Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/development-of-a-computable-phenotype-for-venous-thrombosis-present-on-admission-the-medical-inpatient-thrombosis-and-hemostasis-mith-study/. Accessed September 22, 2023.

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