{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:17:09Z","timestamp":1787505429554,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01 CX002040\u201001"],"award-info":[{"award-number":["I01 CX002040\u201001"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000864","name":"Michael J. Fox Foundation for Parkinson's Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Electronic medical record (EMR)\u2013based studies hold great potential for epidemiologic investigations of Parkinson's disease (PD) causal factors and phenomenology, but diagnostic misclassification may obscure or bias inferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aims were to determine the validity of PD diagnostic codes in the Veterans Administration (VA) national electronic medical databases and develop recommendations for maximizing ascertainment accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated a cohort of 146,776 veterans who utilized VA healthcare between 1999 and 2021. We reviewed the medical records of individuals with a PD International Classification of Diseases (ICD) code in outpatient, inpatient, or community care encounters to assign a gold\u2010standard diagnosis. We determined diagnostic accuracy based on provider type, coding frequency, medications, and potentially exclusionary ICD codes overall and by race.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 377 of 810 (46.5%) with a PD ICD code had PD. Veterans whose PD was coded by a PD\u2010specialist neurologist were most likely to have PD (83.6%), but sensitivity was low (15.0%). Diagnostic accuracy decreased for PD coded by any neurologist (66.9%), but sensitivity improved (69.4%). Requiring two or more PD codes in combination with two or more levodopa prescriptions improved accuracy, particularly among nonneurologists. Neuroleptic\u2010induced parkinsonism was the most frequent diagnosis in those without PD (15.6%). Accuracy was lower in Black (29.0%) than White (50.5%) veterans regardless of provider type (miscoding odds ratio 2.5, 95% confidence interval 1.7\u20133.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      These results highlight the limitations of EMR\u2010based PD ascertainment. Researchers can maximize accuracy by considering provider specialty, coding frequency, pharmacy data, and exclusionary diagnoses, but some degree of record review is required to ensure high accuracy. Higher miscoding among Black veterans warrants further study. \u00a9 2024 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.30075","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:43:22Z","timestamp":1733287402000},"page":"245-253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Validation of Parkinson's Disease Ascertainment in the Veterans Administration Electronic Medical Record"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3039-9927","authenticated-orcid":false,"given":"Samuel M.","family":"Goldman","sequence":"first","affiliation":[{"name":"Division of Occupational, Environmental, and Climate Medicine Department of Medicine, University of California San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Hines Veterans Affairs Hospital, Center of Innovation for Complex Chronic Healthcare  Hines Illinois USA"},{"name":"Parkinson School of Health Sciences and Public Health, Loyola University  Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lishan","family":"Cao","sequence":"additional","affiliation":[{"name":"Hines Veterans Affairs Hospital, Center of Innovation for Complex Chronic Healthcare  Hines Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Geriatrics and Extended Care Data Analysis Center, Canandaigua VA Medical Center  Canandaigua New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Stroupe","sequence":"additional","affiliation":[{"name":"Hines Veterans Affairs Hospital, Center of Innovation for Complex Chronic Healthcare  Hines Illinois USA"},{"name":"Parkinson School of Health Sciences and Public Health, Loyola University  Maywood Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalea","family":"Colletta","sequence":"additional","affiliation":[{"name":"Hines Veterans Affairs Hospital, Center of Innovation for Complex Chronic Healthcare  Hines Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamil","family":"Jugnundan","sequence":"additional","affiliation":[{"name":"Division of Occupational, Environmental, and Climate Medicine Department of Medicine, University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-8562","authenticated-orcid":false,"given":"Ethan G.","family":"Brown","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Neurology Weill Institute for Neurosciences, University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Tanner","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Health Care System  San Francisco California USA"},{"name":"Department of Neurology Weill Institute for Neurosciences, University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032315-021353"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2012-001145"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00030-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198736"},{"key":"e_1_2_10_6_1","unstructured":"U.S. Department of Veterans Affairs HSRD.Corporate Data Warehouse 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Veteran Health Equity Report \u2013 Black or African American Veteran Chartbook. Focus on Veterans Health Administration Patient Experience and Health Care Quality. In: VHA Office of Health Equity, Editor","author":"Washington DL","year":"2023"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2023.09.033"},{"key":"e_1_2_10_27_1","first-page":"3:100061","article-title":"Identifying incident Parkinson's disease using administrative diagnostic codes: a validation study","author":"Peterson BJ","year":"2020","journal-title":"Clin Park Relat Disord"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12318"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27802"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.30075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:30:19Z","timestamp":1760959819000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.30075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,4]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/mds.30075"],"URL":"https:\/\/doi.org\/10.1002\/mds.30075","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,4]]},"assertion":[{"value":"2024-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}