National Healthcare Quality and Disparities Report
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- Clinical Decision Support (CDS) (1)
- (-) Dementia (4)
- Diagnostic Safety and Quality (2)
- (-) Electronic Health Records (EHRs) (4)
- Health Information Technology (HIT) (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedColey RY, Smith JJ, Karliner L RY, Smith JJ, Karliner L
External validation of the eRADAR risk score for detecting undiagnosed dementia in two real-world healthcare systems.
Drupal date: Feb, 2023
It is estimated that half of the individuals with dementia remain undiagnosed. The electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule (eRADAR) was designed to detect older adults at risk of undiagnosed dementia using routinely gathered clinical information. The purpose of this retrospective cohort study was to externally validate eRADAR in two real-world healthcare systems, examining its performance over time and across race/ethnicity. The study found a total of 7631 dementia diagnoses were observed at KPWA and 216 at UCSF. The area under the curve was 0.84 (95% confidence interval: 0.84-0.85) at KPWA and 0.79 (0.76-0.82) at UCSF. Using the 90th percentile as the cut point for identifying high-risk patients, sensitivity was 54% (53-56%) at KPWA and 44% (38-51%) at UCSF. Performance was consistent over time, including across the transition from International Classification of Diseases, version 9 (ICD-9) to ICD-10 codes, and across racial/ethnic groups (although small samples limited precision in some groups). The study concluded that eRADAR demonstrated strong external validity for identifying undiagnosed dementia in two healthcare systems with diverse patient populations and varying availability of external healthcare data for risk calculations. This study showed that eRADAR is generalizable from a research sample to real-world clinical populations, transportable across health systems, resilient to temporal changes in healthcare, and exhibits similar performance across major racial/ethnic groups.
It is estimated that half of the individuals with dementia remain undiagnosed. The electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule (eRADAR) was designed to detect older adults at risk of undiagnosed dementia using routinely gathered clinical information. The purpose of this retrospective cohort study was to externally validate eRADAR in two real-world healthcare systems, examining its performance over time and across race/ethnicity. The study found a total of 7631 dementia diagnoses were observed at KPWA and 216 at UCSF. The area under the curve was 0.84 (95% confidence interval: 0.84-0.85) at KPWA and 0.79 (0.76-0.82) at UCSF. Using the 90th percentile as the cut point for identifying high-risk patients, sensitivity was 54% (53-56%) at KPWA and 44% (38-51%) at UCSF. Performance was consistent over time, including across the transition from International Classification of Diseases, version 9 (ICD-9) to ICD-10 codes, and across racial/ethnic groups (although small samples limited precision in some groups). The study concluded that eRADAR demonstrated strong external validity for identifying undiagnosed dementia in two healthcare systems with diverse patient populations and varying availability of external healthcare data for risk calculations. This study showed that eRADAR is generalizable from a research sample to real-world clinical populations, transportable across health systems, resilient to temporal changes in healthcare, and exhibits similar performance across major racial/ethnic groups.
AHRQ-funded; HS026369.
Citation: Coley RY, Smith JJ, Karliner L RY, Smith JJ, Karliner L .
External validation of the eRADAR risk score for detecting undiagnosed dementia in two real-world healthcare systems.
J Gen Intern Med 2023 Feb; 38(2):351-60. doi: 10.1007/s11606-022-07736-6..
Keywords: Dementia, Neurological Disorders, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Barnes DE, Zhou J, Walker RL
Development and validation of eRADAR: a tool using EHR Data to detect unrecognized dementia.
The goal of this retrospective cohort study was to develop and validate an electronic health record (EHR)-based tool to help detect patients with unrecognized dementia. The tool was named EHR Risk of Alzheimer’s and Dementia Assessment Rule (eRADAR). This study was conducted at Kaiser Permanente Washington (KPWA) using participants in the Adult Changes in Thought (ACT) study who undergo comprehensive testing every 2 years to detect and diagnose dementia and have linked KPWA EHR data. Overall, 1015 ACT visits resulted in a diagnosis of incident dementia, of which 49% were previously unrecognized in the EHR. The final 31-predictor model included markers of dementia-related symptoms, healthcare utilization patterns, and dementia risk factors. The study showed good discrimination in the development interval and validation samples.
AHRQ-funded; HS022982.
Citation: Barnes DE, Zhou J, Walker RL .
Development and validation of eRADAR: a tool using EHR Data to detect unrecognized dementia.
J Am Geriatr Soc 2020 Jan;68(1):103-11. doi: 10.1111/jgs.16182..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Dementia, Neurological Disorders, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Shared Decision Making
Simon KC, Yucus C, Castle J
Building of EMR tools to support quality and research in a memory disorders clinic.
This article describes the development of a customized EMR toolkit that standardizes patient data collection with hundreds of discrete fields, supports Best Practices for treating patients with memory disorders, and also supports practice-based research. The toolkit was successfully implemented to support Best Practices in the care of patients with memory disorders. Applications are also discussed. Data collection is ongoing, but the authors anticipate that the toolkit will generate data that allows for descriptive and hypothesis-driven research as well as quality improvement among patients seen in memory clinics.
AHRQ-funded; HS024057.
Citation: Simon KC, Yucus C, Castle J .
Building of EMR tools to support quality and research in a memory disorders clinic.
Front Neurol 2019 Mar 7;10:161. doi: 10.3389/fneur.2019.00161..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Quality of Care, Quality Improvement, Tools & Toolkits
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention