{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:36:35Z","timestamp":1789050995851,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop and evaluate the classification accuracy of a computable phenotype for pediatric Crohn's disease using electronic health record data from PEDSnet, a large, multi\u2010institutional research network and Learning Health System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Using clinician and informatician input, algorithms were developed using combinations of diagnostic and medication data drawn from the PEDSnet clinical dataset which is comprised of 5.6 million children from eight U.S. academic children's health systems. Six test algorithms (four cases, two non\u2010cases) that combined use of specific medications for Crohn's disease plus the presence of Crohn's diagnosis were initially tested against the entire PEDSnet dataset. From these, three were selected for performance assessment using manual chart review (primary case algorithm, n = 360, primary non\u2010case algorithm, n = 360, and alternative case algorithm, n = 80). Non\u2010cases were patients having gastrointestinal diagnoses other than inflammatory bowel disease. Sensitivity, specificity, and positive predictive value (PPV) were assessed for the primary case and primary non\u2010case algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the six algorithms tested, the least restrictive algorithm requiring just \u22651 Crohn's diagnosis code yielded 11\u2009950 cases across PEDSnet (prevalence 21\/10\u2009000). The most restrictive algorithm requiring \u22653 Crohn's disease diagnoses plus at least one medication yielded 7868 patients (prevalence 14\/10\u2009000). The most restrictive algorithm had the highest PPV (95%) and high sensitivity (91%) and specificity (94%). False positives were due primarily to a diagnosis reversal (from Crohn's disease to ulcerative colitis) or having a diagnosis of \u201cindeterminate colitis.\u201d False negatives were rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using diagnosis codes and medications available from PEDSnet, we developed a computable phenotype for pediatric Crohn's disease that had high specificity, sensitivity and predictive value. This process will be of use for developing computable phenotypes for other pediatric diseases, to facilitate cohort identification for retrospective and prospective studies, and to optimize clinical care through the PEDSnet Learning Health System.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.10243","type":"journal-article","created":{"date-parts":[[2020,8,29]],"date-time":"2020-08-29T02:30:49Z","timestamp":1598668249000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Development and evaluation of an\n                    <scp>EHR<\/scp>\n                    \u2010based computable phenotype for identification of pediatric Crohn's disease patients in a National Pediatric Learning Health System"],"prefix":"10.1002","volume":"4","author":[{"given":"Ritu","family":"Khare","sequence":"first","affiliation":[{"name":"IQVIA  Plymouth Meeting Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Kappelman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Department of Pediatrics University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Samson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology &amp; Nutrition; Department of Pediatrics Washington University in St Louis School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Pyrzanowski","sequence":"additional","affiliation":[{"name":"Adult and Child Consortium for Outcomes Research and Dissemination Science University of Colorado Denver  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul A.","family":"Darwar","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia PA and Department of Pediatrics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles C.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia PA and Department of Pediatrics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Margolis","sequence":"additional","affiliation":[{"name":"James M. Anderson Center for Health Systems Excellence, Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7085-6259","authenticated-orcid":false,"given":"Amanda","family":"Dempsey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Denver  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"And the PEDSnet Computable Phenotype Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2014-002743"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2013-001926"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000907"},{"key":"e_1_2_10_5_1","unstructured":"HutflessS et al. Pharmacological Management of Crohn's Disease: Future Research Needs: Identification of Future Research Needs from Comparative Effectiveness Review No. 131.2014. Rockville MD."},{"key":"e_1_2_10_6_1","unstructured":"HutflessS et al. Pharmacologic Therapies for the Management of Crohn's Disease: Comparative Effectiveness.2014. Rockville MD."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0127"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocx033"},{"key":"e_1_2_10_9_1","unstructured":"BaileyLC et al. PEDSnet: from building a high\u2010quality CDRN to conducting science. In AMIA Annual Symposium2016.2016. Chicago IL."},{"key":"e_1_2_10_10_1","unstructured":"KhareR et al. Identifying and understanding data quality issues in a pediatric distributed research network. In Americal Medical Informatics Association Anuual Symposium 2015.2015: San Francisco CA."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2010.03.003"},{"key":"e_1_2_10_12_1","unstructured":"National Library of Medicine.RxNorm.https:\/\/www.nlm.nih.gov\/research\/umls\/rxnorm\/index.html."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31805563f3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2371-5"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_16_1","first-page":"574","article-title":"Observational health data sciences and informatics (OHDSI): Opportunities for observational researchers","volume":"216","author":"Hripcsak G","year":"2015","journal-title":"Stud Health Technol Inform"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000183350.46795.42"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2014.02.019"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3174-7"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009735"}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.10243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lrh2.10243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.10243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T14:26:24Z","timestamp":1693837584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.10243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,28]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1002\/lrh2.10243"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.10243","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,28]]},"assertion":[{"value":"2020-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e10243"}}