Who is pregnant? Defining real-world data-based pregnancy episodes in the National COVID Cohort Collaborative (N3C).
COVID-19
algorithms
electronic health records
gestational age
pregnancy
Journal
JAMIA open
ISSN: 2574-2531
Titre abrégé: JAMIA Open
Pays: United States
ID NLM: 101730643
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
03
03
2023
revised:
12
05
2023
accepted:
08
08
2023
medline:
21
8
2023
pubmed:
21
8
2023
entrez:
21
8
2023
Statut:
epublish
Résumé
To define pregnancy episodes and estimate gestational age within electronic health record (EHR) data from the National COVID Cohort Collaborative (N3C). We developed a comprehensive approach, named Hierarchy and rule-based pregnancy episode Inference integrated with Pregnancy Progression Signatures (HIPPS), and applied it to EHR data in the N3C (January 1, 2018-April 7, 2022). HIPPS combines: (1) an extension of a previously published pregnancy episode algorithm, (2) a novel algorithm to detect gestational age-specific signatures of a progressing pregnancy for further episode support, and (3) pregnancy start date inference. Clinicians performed validation of HIPPS on a subset of episodes. We then generated pregnancy cohorts based on gestational age precision and pregnancy outcomes for assessment of accuracy and comparison of COVID-19 and other characteristics. We identified 628 165 pregnant persons with 816 471 pregnancy episodes, of which 52.3% were live births, 24.4% were other outcomes (stillbirth, ectopic pregnancy, abortions), and 23.3% had unknown outcomes. Clinician validation agreed 98.8% with HIPPS-identified episodes. We were able to estimate start dates within 1 week of precision for 475 433 (58.2%) episodes. 62 540 (7.7%) episodes had incident COVID-19 during pregnancy. HIPPS provides measures of support for pregnancy-related variables such as gestational age and pregnancy outcomes based on N3C data. Gestational age precision allows researchers to find time to events with reasonable confidence. We have developed a novel and robust approach for inferring pregnancy episodes and gestational age that addresses data inconsistency and missingness in EHR data.
Identifiants
pubmed: 37600074
doi: 10.1093/jamiaopen/ooad067
pii: ooad067
pmc: PMC10432357
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ooad067Subventions
Organisme : NCATS NIH HHS
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Investigateurs
Adam B Wilcox
(AB)
Adam M Lee
(AM)
Alexis Graves
(A)
Alfred Jerrod Anzalone
(AJ)
Amin Manna
(A)
Amit Saha
(A)
Amy Olex
(A)
Andrea Zhou
(A)
Andrew E Williams
(AE)
Andrew Southerland
(A)
Andrew T Girvin
(AT)
Anita Walden
(A)
Anjali A Sharathkumar
(AA)
Benjamin Amor
(B)
Benjamin Bates
(B)
Brian Hendricks
(B)
Brijesh Patel
(B)
Caleb Alexander
(C)
Carolyn Bramante
(C)
Cavin Ward-Caviness
(C)
Charisse Madlock-Brown
(C)
Christine Suver
(C)
Christopher Chute
(C)
Christopher Dillon
(C)
Chunlei Wu
(C)
Clare Schmitt
(C)
Cliff Takemoto
(C)
Dan Housman
(D)
Davera Gabriel
(D)
David A Eichmann
(DA)
Diego Mazzotti
(D)
Don Brown
(D)
Eilis Boudreau
(E)
Elizabeth Zampino
(E)
Emily Carlson Marti
(EC)
Emily R Pfaff
(ER)
Evan French
(E)
Farrukh M Koraishy
(FM)
Federico Mariona
(F)
Fred Prior
(F)
George Sokos
(G)
Greg Martin
(G)
Harold Lehmann
(H)
Heidi Spratt
(H)
Hemalkumar Mehta
(H)
Hongfang Liu
(H)
Hythem Sidky
(H)
J W Awori Hayanga
(JW)
Jami Pincavitch
(J)
Jaylyn Clark
(J)
Jeremy Richard Harper
(JR)
Jessica Islam
(J)
Jin Ge
(J)
Joel Gagnier
(J)
Joel H Saltz
(JH)
Johanna Loomba
(J)
John Buse
(J)
Jomol Mathew
(J)
Joni L Rutter
(JL)
Justin Starren
(J)
Karen Crowley
(K)
Katie Rebecca Bradwell
(KR)
Kellie M Walters
(KM)
Ken Wilkins
(K)
Kenneth R Gersing
(KR)
Kenrick Dwain Cato
(KD)
Kimberly Murray
(K)
Kristin Kostka
(K)
Lavance Northington
(L)
Lee Allan Pyles
(LA)
Leonie Misquitta
(L)
Lesley Cottrell
(L)
Lili Portilla
(L)
Mariam Deacy
(M)
Mark M Bissell
(MM)
Marshall Clark
(M)
Mary Emmett
(M)
Mary Morrison Saltz
(MM)
Matvey B Palchuk
(MB)
Meredith Adams
(M)
Meredith Temple-O'Connor
(M)
Michael G Kurilla
(MG)
Michele Morris
(M)
Nabeel Qureshi
(N)
Nasia Safdar
(N)
Nicole Garbarini
(N)
Noha Sharafeldin
(N)
Ofer Sadan
(O)
Patricia A Francis
(PA)
Penny Wung Burgoon
(PW)
Peter Robinson
(P)
Philip R O Payne
(PRO)
Rafael Fuentes
(R)
Randeep Jawa
(R)
Rebecca Erwin-Cohen
(R)
Rena Patel
(R)
Richard A Moffitt
(RA)
Richard L Zhu
(RL)
Rishi Kamaleswaran
(R)
Robert Hurley
(R)
Robert T Miller
(RT)
Saiju Pyarajan
(S)
Sam G Michael
(SG)
Samuel Bozzette
(S)
Sandeep Mallipattu
(S)
Satyanarayana Vedula
(S)
Scott Chapman
(S)
Shawn T O'Neil
(ST)
Soko Setoguchi
(S)
Stephanie S Hong
(SS)
Steve Johnson
(S)
Tellen D Bennett
(TD)
Tiffany Callahan
(T)
Umit Topaloglu
(U)
Usman Sheikh
(U)
Valery Gordon
(V)
Vignesh Subbian
(V)
Warren A Kibbe
(WA)
Wenndy Hernandez
(W)
Will Beasley
(W)
Will Cooper
(W)
William Hillegass
(W)
Xiaohan Tanner Zhang
(XT)
Commentaires et corrections
Type : UpdateOf
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Déclaration de conflit d'intérêts
K.R.B. and S.L. are employees of Palantir Technologies. Y.K. and L.L. are employees of Sema4. M.N.L. is Managing Director of IPQ Analytics, LLC.
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