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. 2011 May;86(5):382-8.
doi: 10.4065/mcp.2010.0802.

Derivation and validation of automated electronic search strategies to identify pertinent risk factors for postoperative acute lung injury

Anas Alsara  1 , David O Warner, Guangxi Li, Vitaly Herasevich, Ognjen Gajic, Daryl J Kor
Affiliations

Derivation and validation of automated electronic search strategies to identify pertinent risk factors for postoperative acute lung injury

Anas Alsara et al. Mayo Clin Proc. 2011 May.

Abstract

Objective: To develop and validate time-efficient automated electronic search strategies for identifying preoperative risk factors for postoperative acute lung injury.

Patients and methods: This secondary analysis of a prospective cohort study included 249 patients undergoing high-risk surgery between November 1, 2005, and August 31, 2006. Two independent data-extraction strategies were compared. The first strategy used a manual review of medical records and the second a Web-based query-building tool. Web-based searches were derived and refined in a derivation cohort of 83 patients and subsequently validated in an independent cohort of 166 patients. Agreement between the 2 search strategies was assessed with percent agreement and Cohen κ statistics.

Results: Cohen κ statistics ranged from 0.34 (95% confidence interval, 0.00-0.86) for amiodarone to 0.85 for cirrhosis (95% confidence interval, 0.57-1.00). Agreement between manual and automated electronic data extraction was almost complete for 3 variables (diabetes mellitus, cirrhosis, H(2)-receptor antagonists), substantial for 3 (chronic obstructive pulmonary disease, proton pump inhibitors, statins), moderate for gastroesophageal reflux disease, and fair for 2 variables (restrictive lung disease and amiodarone). Automated electronic queries outperformed manual data collection in terms of sensitivities (median, 100% [range, 77%-100%] vs median, 87% [range, 0%-100%]). The specificities were uniformly high (≥ 96%) for both search strategies.

Conclusion: Automated electronic query building is an iterative process that ultimately results in accurate, highly efficient data extraction. These strategies may be useful for both clinicians and researchers when determining the risk of time-sensitive conditions such as postoperative acute lung injury.

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Figures

FIGURE.
FIGURE.
Electronic query for identifying a diagnosis of diabetes mellitus (DM) in the study population. HPI = history of present illness; MCLSS = Mayo Clinic Life Sciences System; PMH/PSH = past medical and surgical history.
See this image and copyright information in PMC

Comment in

References

    1. Hudson LD, Steinberg KP, Stapleton RD, Wang BM, Rubenfeld GD, Caldwell ES. Epidemiology of acute lung injury and ARDS. Chest. 1999;116:74S-82S - PubMed
    1. Stapleton RD, Wang BM, Hudson LD, Rubenfeld GD, Caldwell ES, Steinberg KP. Causes and timing of death in patients with ARDS. Chest. 2005;128:525-532 - PubMed
    1. Fernandez-Perez ER, Sprung J, Afessa B, et al. Intraoperative ventilator settings and acute lung injury after elective surgery: a nested case control study. Thorax. 2009;64:121-127 - PubMed
    1. Kutlu CA, Williams EA, Evans TW, Pastorino U, Goldstraw P. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg. 2000;69:376-380 - PubMed
    1. Ruffini E, Parola A, Papalia E, et al. Frequency and mortality of acute lung injury and acute respiratory distress syndrome after pulmonary resection for bronchogenic carcinoma. Eur J Cardiothorac Surg. 2001;20:30-36, discussion 36-37 - PubMed

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