{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:52:34Z","timestamp":1781563954929,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Background:<\/jats:title>\n Because alpha-1 antitrypsin deficiency is severely underrecognized and delayed diagnosis is associated with harm, strategies to enhance early detection of alpha-1 antitrypsin deficiency are needed.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The study intervention was placing a reminder to test for alpha-1 antitrypsin deficiency within an electronic medical record health maintenance dashboard that houses prompts to providers to implement guideline-based recommendations. This recommendation was for all patients assigned a diagnosis of COPD based on relevant International Classification of Diseases, Tenth Revision codes. The rate of testing for and detecting individuals with alpha-1 antitrypsin deficiency was assessed in 12 one-month intervals before and after implementing the dashboard.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n After the prompt, whereas testing was still performed in only a small percentage of guideline-concordant instances, the rate of testing for alpha-1 antitrypsin deficiency increased 3.8-fold (ie, from 1.2% to 4.6%,\n P<\/jats:italic>\n < .05). This did not result in detection of new patients with alpha-1 antitrypsin deficiency. The rate of testing increased both for alpha-1 antitrypsin serum levels and genotypes in each month after the intervention, though the rate of genotype testing was 2\u20135-fold lower than the rate of testing for serum level.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The results of this preliminary study of a detection strategy for alpha-1 antitrypsin deficiency show that placing a reminder to test for alpha-1 antitrypsin deficiency when indicated in an electronic medical record health maintenance dashboard significantly increased the frequency of testing. Still, that only 4.6% of those in whom testing for alpha-1 antitrypsin deficiency was indicated were tested in the post-intervention period shows that, as for all other alpha-1 antitrypsin deficiency\u2013targeted detection interventions to date, the impact of the intervention was marginal and that other strategies remain needed to mitigate underrecognition. A focus on combining targeted detection strategies (eg, coupling enhanced awareness with free testing) and population-based screening for alpha-1 antitrypsin deficiency is suggested.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/respcare.12200","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T11:57:23Z","timestamp":1736769443000},"page":"74-80","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["An Electronic Health Record\u2013Based Strategy to Enhance Detection of Alpha-1 Antitrypsin Deficiency"],"prefix":"10.1177","volume":"70","author":[{"given":"Avantika","family":"Nathani","sequence":"first","affiliation":[{"name":"Dr. Nathani is affiliated with Integrated Hospital Care Institute, Respiratory, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K.","family":"Stoller","sequence":"additional","affiliation":[{"name":"Dr. Stoller is affiliated with Integrated Hospital Care Institute, Respiratory, Cleveland Clinic, Cleveland, Ohio; and Education Institute Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.168.7.818"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4.1989"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1658"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02817"},{"issue":"2","key":"e_1_3_4_6_2","first-page":"190","article-title":"Improving screening for alpha-1 antitrypsin deficiency with direct testing in the pulmonary function testing laboratory","volume":"8","author":"Gurevich S","year":"2021","unstructured":"Gurevich S, , Daya A, , Da Silva C, et al. Improving screening for alpha-1 antitrypsin deficiency with direct testing in the pulmonary function testing laboratory. Chronic Obstr Pulm Dis Miami Dis. 2021; 8(2):190\u2013197.","journal-title":"Chronic Obstr Pulm Dis Miami Dis"},{"issue":"1","key":"e_1_3_4_7_2","first-page":"26","article-title":"A novel detection method to identify individuals with alpha-1 antitrypsin deficiency: linking prescription of COPD medications with the patient-facing electronic medical record","volume":"9","author":"Lam SW","year":"2022","unstructured":"Lam SW, , Strange C, , Brantly ML, et al. A novel detection method to identify individuals with alpha-1 antitrypsin deficiency: linking prescription of COPD medications with the patient-facing electronic medical record. Chronic Obstr Pulm Dis Miami Dis. 2022; 9(1):26\u201333.","journal-title":"Chronic Obstr Pulm Dis Miami Dis"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S208591"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06555"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-023-02338-0"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201506-349KV"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10550322"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.04.023"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.02012001"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/15412550802587927"},{"key":"e_1_3_4_16_2","doi-asserted-by":"crossref","unstructured":"Choudry SA Choudry AB Lee MD. Alpha-1 antitrypsin genotype screening in COPD patient identified via EMR. C101. new insights into alpha-1 antitrypsin deficiency and outcomes following COPD exacerbations. American Thoracic Society:A5353\u2013A5353","DOI":"10.1164\/ajrccm-conference.2011.183.1_MeetingAbstracts.A5353"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-016-0453-8"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/respcare.12200","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12200","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12200","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:36:42Z","timestamp":1777685802000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/respcare.12200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1089\/respcare.12200"],"URL":"https:\/\/doi.org\/10.1089\/respcare.12200","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,10]]}}}