Katherine N. Cahill, MD, Christina B

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Presentation transcript:

Automated identification of an aspirin-exacerbated respiratory disease cohort Katherine N. Cahill, MD, Christina B. Johns, BA, Jing Cui, MD, PhD, Paige Wickner, MD, MPH, David W. Bates, MD, MSc, Tanya M. Laidlaw, MD, Patrick E. Beeler, MD Journal of Allergy and Clinical Immunology Volume 139, Issue 3, Pages 819-825.e6 (March 2017) DOI: 10.1016/j.jaci.2016.05.048 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Venn diagram of the clinical characteristics of cases identified by an AERD bioinformatics algorithm. From 2,647,842 patients aged 18 years and older seen within the Partners Healthcare system between December 2004 and November 2014, we identified cases with a diagnosis of asthma, nasal polyps, and/or NSAID allergy. NSAID allergy was restricted to only those with a specified respiratory reaction to NSAIDs or an unspecified (“unknown”) reaction. The cohort of “possible AERD” cases, in yellow, lies at the intersection of all 3 clinical characteristics. n represents sample size. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Flowchart for the assessment of the possible AERD cohort. The PPV for identifying AERD in subjects with asthma, nasal polyposis, and a recorded respiratory reaction to an NSAID (cohort A) was 88.7%. The PPV for identifying subjects with AERD having a recorded respiratory or unspecified reaction to an NSAID (cohorts A + B) not previously enrolled in the AERD registry was 78.4%. The PPV for algorithm identifying all patients with AERD (cohort A + cohort B + AERD registry) was 81.1%. n represents sample size. *A total of 732 charts were initially identified by the algorithm and 1 test chart was excluded. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Venn diagram of the possible AERD cases identified by the AERD algorithm (SQL #1-3), AERD-specific search terms (SQL #4), and the BWH AERD registry. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 SQL query #1 developed to identify a patient population with asthma. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 SQL query #2 developed to identify a patient population with nasal polyps. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 SQL query #3 developed to identify a patient population with NSAID hypersensitivity reactions typical of the respiratory symptoms triggered by NSAIDs in AERD or charts that reported unspecified (“unknown”) reactions to NSAIDs. Asa, Aspirin; Sob, shortness of breath. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 SQL query #3 developed to identify a patient population with NSAID hypersensitivity reactions typical of the respiratory symptoms triggered by NSAIDs in AERD or charts that reported unspecified (“unknown”) reactions to NSAIDs. Asa, Aspirin; Sob, shortness of breath. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 SQL query #4 developed to identify a patient population with known or suspected AERD. Asa, Aspirin; Sob, shortness of breath. Journal of Allergy and Clinical Immunology 2017 139, 819-825.e6DOI: (10.1016/j.jaci.2016.05.048) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions