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dc.contributor.authorKohane, Isaac
dc.contributor.authorMandl, Kenneth D.
dc.contributor.authorReis, Ben Y.
dc.date.accessioned2010-07-14T15:23:10Z
dc.date.available2010-07-14T15:23:10Z
dc.date.issued2009-05
dc.identifier.issn0959-8146
dc.identifier.issn0959-8138
dc.identifier.urihttp://hdl.handle.net/1721.1/56293
dc.descriptionhttp://www.bmj.com/content/339/bmj.b3677
dc.description.abstractObjective To determine whether longitudinal data in patients’ historical records, commonly available in electronic health record systems, can be used to predict a patient’s future risk of receiving a diagnosis of domestic abuse. Design Bayesian models, known as intelligent histories, used to predict a patient’s risk of receiving a future diagnosis of abuse, based on the patient’s diagnostic history. Retrospective evaluation of the model’s predictions using an independent testing set. Setting A state-wide claims database covering six years of inpatient admissions to hospital, admissions for observation, and encounters in emergency departments. Population All patients aged over 18 who had at least four years between their earliest and latest visits recorded in the database (561 216 patients). Main outcome measures Timeliness of detection, sensitivity, specificity, positive predictive values, and area under the ROC curve. Results 1.04% (5829) of the patients met the narrow case definition for abuse, while 3.44% (19 303) met the broader case definition for abuse. The model achieved sensitive, specific (area under the ROC curve of 0.88), and early (10-30 months in advance, on average) prediction of patients’ future risk of receiving a diagnosis of abuse. Analysis of model parameters showed important differences between sexes in the risks associated with certain diagnoses. Conclusions Commonly available longitudinal diagnostic data can be useful for predicting a patient’s future risk of receiving a diagnosis of abuse. This modelling approach could serve as the basis for an early warning system to help doctors identify high risk patients for further screening.en_US
dc.description.sponsorshipNational Library of Medicine (grants R01 LM009879, R01 LM007677, and G08LM009778)en_US
dc.description.sponsorshipCenters for Disease Control and Prevention (U.S.) (grant R01 PH000040)en_US
dc.language.isoen_US
dc.publisherBritish Medical Associationen_US
dc.rightsArticle is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.en_US
dc.sourceBMJ Publishing Groupen_US
dc.titleLongitudinal histories as predictors of future diagnoses of domestic abuse: modelling studyen_US
dc.typeArticleen_US
dc.identifier.citationReis, Ben Y., Isaac S. Kohane and Kenneth D. Mandl. "Longitudinal histories as predictors of future diagnoses of domestic abuse: modelling study." BMJ 2009;339:b3677. © 2009 British Medical Association.en_US
dc.contributor.departmentHarvard University--MIT Division of Health Sciences and Technologyen_US
dc.contributor.approverMandl, Kenneth D.
dc.contributor.mitauthorKohane, Isaac
dc.contributor.mitauthorMandl, Kenneth D.
dc.contributor.mitauthorReis, Ben Y.
dc.relation.journalBMJ: British medical journalen_US
dc.eprint.versionFinal published versionen_US
dc.type.urihttp://purl.org/eprint/type/JournalArticleen_US
eprint.statushttp://purl.org/eprint/status/PeerRevieweden_US
dspace.orderedauthorsReis, Ben Y.; Kohane, Isaac S.; Mandl, Kenneth D.
mit.licensePUBLISHER_POLICYen_US
mit.metadata.statusComplete


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