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How to validate a diagnosis recorded in electronic health records

Francis Nissen, Jennifer K. Quint, Daniel R. Morales, Ian J. Douglas
Breathe 2019 15: 64-68; DOI: 10.1183/20734735.0344-2018
Francis Nissen
1Dept of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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  • For correspondence: francis.nissen@lshtm.ac.uk
Jennifer K. Quint
2National Heart and Lung Institute, Imperial College, London, UK
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Daniel R. Morales
3Division of Population Health and Genomics, University of Dundee, Dundee, UK
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Ian J. Douglas
1Dept of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Tables

  • Table 1

    Test measures

    Reference standardOutcomeTest measures
    PositiveNegative
    Diagnostic algorithm
     PositiveTrue positives correctly identified (A)False positives (B)Total identified as positivePPV=A/(A+B)
     NegativeFalse negatives (C)True negatives correctly identified (D)Total identified as negativeNPV=D/(C+D)
    OutcomeTrue positivesTrue negatives
    Test measuresSensitivity=A/(A+C)Specificity=D/(B+D)
  • Table 2

    Test measures that it is possible to calculate or estimate by each validation technique

    TechniquePPVNPVSensitivitySpecificity
    Manual validation of physical recordsCan be calculatedCan be calculatedCan be calculatedCan be calculated
    Questionnaires for healthcare practitioners or patientsCan be calculatedCan be calculated
    Validation of machine-learning algorithmsCan be calculatedCan be calculatedCan be calculatedCan be calculated
    Comparison to an external database (complete overlap)Can be calculatedCan be calculatedCan be calculatedCan be calculated
    Comparison of rates in a comparable populationEstimate onlyEstimate only
    Internal validation using additional parametersEstimate onlyEstimate only
    Internal validation using free text in the databaseEstimate onlyEstimate only
    Sensitivity analyses using restrictive algorithms
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How to validate a diagnosis recorded in electronic health records
Francis Nissen, Jennifer K. Quint, Daniel R. Morales, Ian J. Douglas
Breathe Mar 2019, 15 (1) 64-68; DOI: 10.1183/20734735.0344-2018

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How to validate a diagnosis recorded in electronic health records
Francis Nissen, Jennifer K. Quint, Daniel R. Morales, Ian J. Douglas
Breathe Mar 2019, 15 (1) 64-68; DOI: 10.1183/20734735.0344-2018
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