{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:18:09Z","timestamp":1789507089404,"version":"build-2803163510"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH Researching COVID to Enhance Recovery (RECOVER) Initiative","award":["OT2HL161847-01"],"award-info":[{"award-number":["OT2HL161847-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Long COVID, characterized by persistent or recurring symptoms post-COVID-19 infection, poses challenges for pediatric care and research due to the lack of a standardized clinical definition. Adult-focused phenotypes do not translate well to children, given developmental and physiological differences, and pediatric-specific phenotypes have not been compared with chart review.<\/jats:p>\n                  <jats:p>This study introduces and evaluates a pediatric-specific rule-based computable phenotype (CP) to identify long COVID using electronic health record data. We compare its performance to manual chart review.<\/jats:p>\n                  <jats:p>We applied the CP, composed of diagnostic codes empirically associated with long COVID, to 339,467 pediatric patients with SARS-CoV-2 infection in the RECOVER PCORnet EHR database. The CP identified 31,781 patients with long COVID. Clinicians conducted chart reviews on a subset of patients across 16 hospital systems to assess performance. We qualitatively reviewed discordant cases to understand differences between CP and clinician identification.<\/jats:p>\n                  <jats:p>Among the 651 reviewed patients (339 females, M\n                  age\u2009=\u200910.10 years), the CP showed moderate agreement with clinician identification (accuracy\u2009=\u20090.62, positive predictive value [PPV]\u2009=\u20090.49, negative predictive value [NPV]\u2009=\u20090.75, sensitivity\u2009=\u20090.52, specificity\u2009=\u20090.84). Performance was largely consistent across age and dominant variant but varied by symptom cluster count. Most discrepancies between the CP and chart review occurred when the CP identified a case, but the clinician did not, often because clinicians attributed symptoms to preexisting conditions (73%). When clinicians identified cases missed by the CP, they often used broader symptom or timing criteria (69%). Model performance improved when the CP accounted for preexisting conditions (accuracy\u2009=\u20090.71, PPV\u2009=\u20090.65, NPV\u2009=\u20090.74, sensitivity\u2009=\u20090.59, specificity\u2009=\u20090.79).<\/jats:p>\n                  <jats:p>This study presents a CP for pediatric long COVID. While agreement with manual review was moderate, most discrepancies were explained by differences in interpreting symptoms when patients had preexisting conditions. Accounting for these conditions improved accuracy and highlights the need for a consensus definition. These findings support the development of reliable, scalable tools for pediatric long COVID research.<\/jats:p>","DOI":"10.1055\/a-2702-1574","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T23:11:06Z","timestamp":1761347466000},"page":"1445-1456","source":"Crossref","is-referenced-by-count":2,"title":["Identifying Pediatric Long COVID: Comparing an EHR Algorithm to Manual Review"],"prefix":"10.1055","volume":"16","author":[{"given":"Morgan","family":"Botdorf","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Dickinson","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaly","family":"Lorman","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanieh","family":"Razzaghi","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Marchesani","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Denver, Colorado, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Rogerson","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Higginbotham","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuncion","family":"Mejias","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Salyakina","sequence":"additional","affiliation":[{"name":"Center for Precision Medicine, Nicklaus Children's Hospital, Miami, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Thacker","sequence":"additional","affiliation":[{"name":"Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dima","family":"Dandachi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Missouri-Columbia, Columbia, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri A.","family":"Christakis","sequence":"additional","affiliation":[{"name":"Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Taylor","sequence":"additional","affiliation":[{"name":"New York University Grossman School of Medicine, RECOVER Patient, Caregiver, or Community Representative, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden T.","family":"Schwenk","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Stanford School of Medicine, Palo Alto, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Morizono","sequence":"additional","affiliation":[{"name":"Center for Genetic Medicine Research, Children's National Hospital, Washington, District of Columbia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Cogen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan M.","family":"Pajor","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Jhaveri","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Charles","family":"Bailey","sequence":"additional","affiliation":[{"name":"Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the RECOVER Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"101019","DOI":"10.1016\/j.eclinm.2021.101019","article-title":"Characterizing long COVID in an international cohort: 7 months of symptoms and their impact","volume":"38","author":"H E Davis","year":"2021","journal-title":"EClinicalMedicine"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1542\/peds.2008-1879","article-title":"Chronic fatigue syndrome after infectious mononucleosis in adolescents","volume":"124","author":"B Z 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RStudio: Integrated Development Environment for R","author":"Posit team"},{"issue":"06","key":"ref29","doi-asserted-by":"crossref","first-page":"e1647","DOI":"10.1542\/peds.2013-3875","article-title":"Pediatric medical complexity algorithm: a new method to stratify children by medical complexity","volume":"133","author":"T D Simon","year":"2014","journal-title":"Pediatrics"},{"issue":"04","key":"ref30","doi-asserted-by":"crossref","first-page":"e002456","DOI":"10.1136\/fmch-2023-002456","article-title":"Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0-5 years in the USA in 2022: a multicentre retrospective cohort study","volume":"11","author":"L Wang","year":"2023","journal-title":"Fam Med Community Health"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1473-3099(23)00684-9","article-title":"Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study","volume":"24","author":"Y Xie","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"104439","DOI":"10.1016\/j.nurpra.2022.08.022","article-title":"Postural orthostatic tachycardia syndrome (POTS): a frequently missed diagnosis","volume":"19","author":"A George","year":"2023","journal-title":"J Nurse Pract"},{"key":"ref34","volume-title":"A long COVID definition: a chronic, systemic disease state with profound consequences","author":"National Academies of Sciences, Engineering, and Medicine","year":"2024"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2702-1574.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T23:11:16Z","timestamp":1761347476000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2702-1574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":29,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,10,17]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2702-1574","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}