{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:03:16Z","timestamp":1790222596431,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2HX003330"],"award-info":[{"award-number":["IK2HX003330"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24 AG AG084923"],"award-info":[{"award-number":["K24 AG AG084923"]}],"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elder abuse (EA) is a serious public health concern that is dramatically under\u2010documented in electronic health records (EHRs). Although structured EHR markers for EA are commonly used in research to identify EA cases in large cohorts due to their accessibility, their validity for capturing clinical EA concerns is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and Setting<\/jats:title>\n                    <jats:p>Of 3,724,639 Veterans aged \u2265\u200960\u2009years with an outpatient Veterans Health Administration (VHA) encounter in 2022, 8161 (0.2%) had an EA\u2010related ICD\u201010 code and\/or a structured social work consult marker for \u201cabuse\/neglect\u201d recorded in the EHR that year. From the 7382 with complete race\/ethnicity data, we randomly sampled 105 veterans for review, intentionally oversampling women and racial\/ethnic minority groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review, systematically abstracting clinical notes within \u00b1180\u2009days of the structured EA marker to assess the positive predictive value (PPV) with 95% confidence intervals (CIs) against a reference standard of documented active clinical EA concerns in free text notes. Descriptive statistics were used to characterize the sample and documentation patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 14 of 105 veterans (PPV [95% CI] 13.3% [7.5\u201321.4]) had free\u2010text documentation of active clinical EA concern: 9 of 77 (11.7% [5.5\u201321.0]) with a social work consult marker, 4 of 27 (14.8% [4.2\u201333.7]) with an ICD\u201010 code, and 1 of 1 (100% [2.5\u2013100.0]) with both. Among the 91 veterans without documented concern, 20 had documentation of historical abuse only (e.g., military sexual trauma), while the remainder had no clear explanation for the administrative marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Structured EA data markers in the VHA EHR rarely corresponded to free\u2010text documentation of active clinical EA concern, raising important questions about their validity as proxies for EA identification. These findings underscore the need for developing standardized, clinician\u2010friendly approaches to EA documentation in EHRs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70738","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:48:10Z","timestamp":1790221690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validating Administrative Data Markers for Elder Abuse Identification via Chart Review in a National Health System"],"prefix":"10.1111","author":[{"given":"Joseph","family":"Shin","sequence":"first","affiliation":[{"name":"VA Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"VA Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria K.","family":"Mor","sequence":"additional","affiliation":[{"name":"VA Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Department of Biostatistics and Health Data Science, School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6638-4121","authenticated-orcid":false,"given":"Tony","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Weill Cornell Medical College\/New\u2010York Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Shin","sequence":"additional","affiliation":[{"name":"VA Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Department of Family Medicine University of Colorado Anschutz  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-1016","authenticated-orcid":false,"given":"Lena K.","family":"Makaroun","sequence":"additional","affiliation":[{"name":"VA Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404688"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341652"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.5.428"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14480"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648211018530"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glab354"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.14375"},{"issue":"2","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/jgs.15170","article-title":"Veterans Experiencing Elder Abuse: Improving Care of a High\u2010Risk Population About Which Little Is Known","volume":"66","author":"Makaroun L. 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