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首页> 外文期刊>AIDS care. >Development of an electronic medical record-based algorithm to identify patients with unknown HIV status
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Development of an electronic medical record-based algorithm to identify patients with unknown HIV status

机译：开发基于电子病历的算法以识别艾滋病毒状况未知的患者

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摘要

Individuals with unknown HIV status are at risk for undiagnosed HIV, but practical and reliable methods for identifying these individuals have not been described. We developed an algorithm to identify patients with unknown HIV status using data from the electronic medical record (EMR) of a large health care system. We developed EMR-based criteria to classify patients as having known status (HIV-positive or HIV-negative) or unknown status and applied these criteria to all patients seen in the affiliated health care system from 2008 to 2012. Performance characteristics of the algorithm for identifying patients with unknown HIV status were calculated by comparing a random sample of the algorithm's results to a reference standard medical record review. The algorithm classifies all patients as having either known or unknown HIV status. Its sensitivity and specificity for identifying patients with unknown status are 99.4% (95% CI: 96.5-100%) and 95.2% (95% CI: 83.8-99.4%), respectively, with positive and negative predictive values of 98.7% (95% CI: 95.5-99.8%) and 97.6% (95% CI: 87.1-99.1%), respectively. Using commonly available data from an EMR, our algorithm has high sensitivity and specificity for identifying patients with unknown HIV status. This algorithm may inform expanded HIV testing strategies aiming to test the untested.
机译：HIV状况不明的个体处于未确诊HIV的危险中，但是没有描述识别这些个体的实用而可靠的方法。我们开发了一种算法，可以使用大型卫生保健系统的电子病历（EMR）中的数据来识别艾滋病毒状况未知的患者。我们开发了基于EMR的标准，将患者分为已知状态（HIV阳性或HIV阴性）或未知状态，并将这些标准应用于2008年至2012年在附属医疗系统中看到的所有患者。该算法的性能特点通过将算法结果的随机样本与参考标准病历审查进行比较，计算出可识别出艾滋病毒状况未知的患者。该算法将所有患者分类为已知或未知HIV状况。其识别未知状态患者的敏感性和特异性分别为99.4％（95％CI：96.5-100％）和95.2％（95％CI：83.8-99.4％），阳性和阴性预测值分别为98.7％（95 ％CI：95.5-99.8％）和97.6％（95％CI：87.1-99.1％）。使用EMR的常用数据，我们的算法具有很高的灵敏度和特异性，可用于识别HIV状况未知的患者。该算法可以为旨在测试未经测试的扩展HIV测试策略提供信息。

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