Lockhart, P., Chu, V., Thornhill, M. orcid.org/0000-0003-0681-4083 et al. (6 more authors) (2022) A high-sensitivity method for identifying a rare subpopulation of patients with infective endocarditis for a prospective case-control study. JADA Foundational Science, 1. 100002. ISSN 2772-414X
Abstract
Background
Infective endocarditis (IE) is an uncommon disease, but it is associated with high morbidity and mortality. The low incidence and varied clinical presentation make identification of these patients recently admitted to hospitals particularly challenging. The authors designed a prospective electronic health record screening tool (PEHRST) to identify inpatients with IE for a prospective case-control study designed to determine levels of association between oral hygiene and periodontal disease indexes and IE.
Methods
The authors used PEHRST to identify, soon after admission, patients hospitalized with IE based on the presence of any 2 of the 4 screening criteria: orders for blood culture or echocardiography and completed consultations from infectious diseases or cardiovascular medicine. They determined the utility of this tool by comparing the prospectively generated PEHRST list of potential inpatients with IE with a retrospective list of inpatients with IE discharged during the same 2-year period.
Results
Of the 74,345 patients admitted during the study period, PEHRST identified 11,944 (16%) with at least 2 of the 4 screening criteria. Retrospective claims data showed that 198 patients were discharged during this time period with an IE diagnosis, all of whom had been identified by PEHRST (sensitivity = 100%; 95% CI, 98.2% to 100%; specificity = 84%; 95% CI, 83.9% to 84.4%). An analysis of the timing of the 4 screening criteria indicated that the median days were all within 24 hours of admission.
Conclusions
PEHRST made possible the identification of rare patients with IE soon after hospital admission with high sensitivity, allowing the parent study to achieve sufficient enrollment of cases for the primary outcome measure.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Author(s). Published by Elsevier Inc. on behalf of the American Dental Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Heart valves; bacteremia; blood culture; cardiology; electronic health records; research methodology |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Funding Information: | Funder Grant number NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA iR01DE023375-01A1 NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA iR01DE023375-01A1 NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA iR01DE023375-01A1 NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA iR01DE023375-01A1 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 18 Feb 2022 12:17 |
Last Modified: | 19 Feb 2022 07:34 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.jfscie.2021.100002 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:156150 |