{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:21:28Z","timestamp":1792171288674,"version":"4.4.0"},"reference-count":57,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2TR001862"],"award-info":[{"award-number":["KL2TR001862"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG073104"],"award-info":[{"award-number":["P30AG073104"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03AG088893"],"award-info":[{"award-number":["R03AG088893"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG069822"],"award-info":[{"award-number":["R33AG069822"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>More than half of older adults with Alzheimer's Disease and Related Dementias (ADRD) are undiagnosed, limiting timely access to person\u2010centered care. Therefore, clinicians, researchers, and population health managers need scalable, reproducible approaches to monitor both prevalence and diagnostic gaps. We evaluated whether a decision\u2010analytic modeling framework can translate a limited number of clinician\u2010adjudicated cases of ADRD into a probabilistic computational phenotype for accurate, population\u2010level assignments of probable ADRD in the emergency department (ED) setting using routinely collected electronic health record (EHR) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 5000 adults aged \u2265\u200965\u2009years from nine EDs within a large integrated health system (2014\u20132022). We randomly selected 500 individuals for clinician adjudication of dementia status (reference cohort), reserving the remaining 4500 as a phenotyping cohort. We developed the phenotype as a logistic regression model trained on adjudicated cases, embedding pattern\u2010mixture multiple imputation to address information bias. We applied decision\u2010curve analysis to evaluate clinical utility across probabilistic thresholds. We applied the phenotype to assign dementia status to 4500 unadjudicated patients and compared clinical characteristics to adjudicated cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean (SD) age was 77.4 (9.0) years; 55.4% were women; 102 individuals (20.4%) had clinician\u2010adjudicated ADRD. The model demonstrated good discrimination (AUROC 0.87; 95% CI 0.82\u20130.91). Decision\u2010curve analysis revealed net clinical benefit across examined thresholds (predicted probabilities 12%\u201332%), identifying an additional 16\u201318 probable ADRD cases per 100 older adults. Among those without ADRD\u2010related diagnosis codes, net benefit ranged from 8 to 13 additional correct identifications per 100. Phenotype\u2010assigned cases closely resembled clinician\u2010adjudicated cases (standardized mean differences \u2264\u20090.20).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A probabilistic computational phenotype derived from routinely collected EHR data accurately reproduced clinician\u2010adjudicated ADRD status and demonstrated net clinical benefit, including among ED patients whose ADRD was not captured by diagnosis codes. Adoption of this replicable framework may enable healthcare organizations to strengthen ADRD surveillance and reduce underdiagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70562","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:04:37Z","timestamp":1783393477000},"page":"2326-2337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4487-6832","authenticated-orcid":false,"given":"Natalia","family":"Festa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2041-2048","authenticated-orcid":false,"given":"Kelsey","family":"Alexovitz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Sifnugel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Population Health NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-2635","authenticated-orcid":false,"given":"Inessa","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-4265","authenticated-orcid":false,"given":"Isaac V.","family":"Faustino","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddarth","family":"Khasnavis","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"},{"name":"Veterans Affairs Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"},{"name":"Veterans Affairs Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Iscoe","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam P.","family":"Mecca","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3715-3073","authenticated-orcid":false,"given":"Ula","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Population Health NYU Grossman School of Medicine  New York New York USA"},{"name":"Geriatrics Research Education Clinical Center James J. Peters VA Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12062\u2010015\u20109112\u20104"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.1179"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.292.8.961"},{"key":"e_1_2_13_5_1","unstructured":"Alzheimer's Association \u201cAlzheimer's Facts and Figures Report \u201d 2025 accessed May 19 2025 https:\/\/www.alz.org\/alzheimers\u2010dementia\/facts\u2010figures."},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010018\u20104377\u2010y"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/AGEING\/AFV020"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.H3029"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA2212948"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.42222"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/DAD2.70051"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14164"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.16022"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-22009-9_577"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN\u20102023\u2010079241"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2019.1566812"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2022.14647"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocad086"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.70334"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.14744"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm\u20102022\u2010112134"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2021.0184"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533148"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.18109"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000393"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.16182"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/S11606\u2010022\u201007736\u20106"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.091835"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000118"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.70287"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14832"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70189"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2019.07.023"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17740"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12883"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl\u20102012\u2010001145"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.17183"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/EMERMED\u20102024\u2010214222"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/JAMIA\/OCAE121"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2024.25056"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/GPS.4880"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.3766\/JAAA.15006"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.00185"},{"key":"e_1_2_13_44_1","volume-title":"Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data","author":"Festa N.","year":"2025"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glab373"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/GERONA\/GLAB377"},{"key":"e_1_2_13_47_1","unstructured":"Centers for Medicare & Medicaid Services \u201cChronic Conditions Warehouse Technical Guidance: Getting Started With CMS Medicare Administrative Research Files Version 2.8 \u201d 2022 https:\/\/www2.ccwdata.org\/documents\/10280\/19002246\/ccw\u2010medicare\u2010data\u2010user\u2010guide.pdf."},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.9679"},{"key":"e_1_2_13_49_1","unstructured":"National Library of Medicine \u201cValue Set Authority Center \u201d 2025 https:\/\/vsac.nlm.nih.gov\/."},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18372"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X211044697"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010019\u20101466\u20107"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41512\u2010019\u20100064\u20107\/figures\/3"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20100697"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.06.017"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17745"},{"key":"e_1_2_13_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13573"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12982\u2010021\u201000095\u20103"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70562","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.70562","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.70562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:11:24Z","timestamp":1787821884000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.70562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":57,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/jgs.70562"],"URL":"https:\/\/doi.org\/10.1111\/jgs.70562","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}