caa a22 4500 606180443 CHVBK 20210128100806.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s11136-014-0764-y doi (NATIONALLICENCE)springer-10.1007/s11136-014-0764-y Incorporating patient-reported outcome measures into the electronic health record for research: application using the Patient Health Questionnaire (PHQ-9) [Elektronische Daten] [Sandra Griffith, Nicolas Thompson, Jaivir Rathore, Lara Jehi, George Tesar, Irene Katzan] Purpose: Electronic health records (EHRs) present an opportunity to access large stores of data for research, but mapping raw EHR data to clinical phenotypes is complex. We propose adding patient-reported data to the EHR to improve phenotyping performance and describe a retrospective cohort study demonstrating a test case in depressive disorder. Methods: We compared four EHR-phenotyping methods based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, medication records, and the Patient Health Questionnaire 9 (PHQ-9) regarding the ability to identify cases with depression and characteristics of patients identified with depression. Our sample included 168,884 patients seen (2007-2013) at our neurological institute. We assessed the diagnostic performance in a subset of 225 patients who had a reference standard measurement available. Results: ICD-9-CM codes identified the fewest number of patients as depressed (4,658), followed by PHQ-9 (46,565), and medication data (50,505). The presence of at least one of these criteria identified the largest number (78,322). The PHQ-9 identified a higher proportion of elderly, disabled, Medicaid, and rural patients, as compared to ICD-9-CM codes. ICD-9-CM codes were least sensitive (6.7% sensitivity), whereas the method using at least one of the criteria identified the highest number of truly depressed patients (93.3% sensitivity); however, specificity dropped from 97.7 to 58.1%. Conclusions: The choice of phenotyping method may disproportionately exclude patient groups from research. Patient-reported data hold potential to improve sensitivity while maintaining an acceptable loss of specificity, depending on the context. Researchers should consider including patient-reported data in EHR-driven phenotyping methods. Springer International Publishing Switzerland, 2014 Electronic health records nationallicence Depressive disorder nationallicence Classification nationallicence Patient outcome assessment nationallicence ICD-9-CM nationallicence Griffith Sandra Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, JJN3-01, 44195, Cleveland, OH, USA aut Thompson Nicolas Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, JJN3-01, 44195, Cleveland, OH, USA aut Rathore Jaivir Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, S51, 44195, Cleveland, OH, USA aut Jehi Lara Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, 44195, Cleveland, OH, USA aut Tesar George Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, S51, 44195, Cleveland, OH, USA aut Katzan Irene Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, 44195, Cleveland, OH, USA aut Quality of Life Research Springer International Publishing 24/2(2015-02-01), 295-303 0962-9343 24:2<295 2015 24 11136 https://doi.org/10.1007/s11136-014-0764-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-014-0764-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Griffith Sandra Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, JJN3-01, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Thompson Nicolas Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, JJN3-01, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Rathore Jaivir Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, S51, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Jehi Lara Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Tesar George Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, S51, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Katzan Irene Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, 44195, Cleveland, OH, USA aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/2(2015-02-01), 295-303 0962-9343 24:2<295 2015 24 11136