使用基于树的扫描统计方法了解儿科长COVID:来自RECOVER计划的基于ehr的队列研究。

IF 2.5 Q2 HEALTH CARE SCIENCES & SERVICES JAMIA Open Pub Date : 2023-04-01 DOI:10.1093/jamiaopen/ooad016
Vitaly Lorman, Suchitra Rao, Ravi Jhaveri, Abigail Case, Asuncion Mejias, Nathan M Pajor, Payal Patel, Deepika Thacker, Seuli Bose-Brill, Jason Block, Patrick C Hanley, Priya Prahalad, Yong Chen, Christopher B Forrest, L Charles Bailey, Grace M Lee, Hanieh Razzaghi
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引用次数: 1

摘要

鉴于SARS-CoV-2感染(PASC)在儿科人群中的表现和严重程度的异质性,其急性后后遗症(PASC)尚未得到很好的定义。本研究的目的是使用依赖于数据挖掘方法而不是临床经验的新方法来检测与儿科PASC相关的条件和症状。材料和方法:我们采用倾向匹配队列设计,比较使用新的PASC ICD10CM诊断代码(U09.9)鉴定的儿童(N = 1309)与感染SARS-CoV-2的儿童(N = 6545)和未感染SARS-CoV-2的儿童(N = 6545)。我们使用基于树的扫描统计来识别病例中比对照组更频繁地共同发生的潜在病症集群。结果:我们发现PASC患儿在心脏、呼吸、神经、心理、内分泌、胃肠和肌肉骨骼系统中有显著的富集,其中最显著的与循环和呼吸系统相关,如呼吸困难、呼吸困难、疲劳和不适。讨论:我们的研究解决了先前研究的方法学局限性,这些研究依赖于由临床医生经验驱动的潜在pasc相关诊断的预先指定集群。未来的研究需要确定诊断模式及其相关性,以获得临床表型。结论:我们确定了与小儿PASC相关的多种疾病和身体系统。由于我们依靠数据驱动的方法,因此发现了一些新的或未报告的病症和症状,值得进一步调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Understanding pediatric long COVID using a tree-based scan statistic approach: an EHR-based cohort study from the RECOVER Program.

Objectives: Post-acute sequalae of SARS-CoV-2 infection (PASC) is not well defined in pediatrics given its heterogeneity of presentation and severity in this population. The aim of this study is to use novel methods that rely on data mining approaches rather than clinical experience to detect conditions and symptoms associated with pediatric PASC.

Materials and methods: We used a propensity-matched cohort design comparing children identified using the new PASC ICD10CM diagnosis code (U09.9) (N = 1309) to children with (N = 6545) and without (N = 6545) SARS-CoV-2 infection. We used a tree-based scan statistic to identify potential condition clusters co-occurring more frequently in cases than controls.

Results: We found significant enrichment among children with PASC in cardiac, respiratory, neurologic, psychological, endocrine, gastrointestinal, and musculoskeletal systems, the most significant related to circulatory and respiratory such as dyspnea, difficulty breathing, and fatigue and malaise.

Discussion: Our study addresses methodological limitations of prior studies that rely on prespecified clusters of potential PASC-associated diagnoses driven by clinician experience. Future studies are needed to identify patterns of diagnoses and their associations to derive clinical phenotypes.

Conclusion: We identified multiple conditions and body systems associated with pediatric PASC. Because we rely on a data-driven approach, several new or under-reported conditions and symptoms were detected that warrant further investigation.

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来源期刊
JAMIA Open
JAMIA Open Medicine-Health Informatics
CiteScore
4.10
自引率
4.80%
发文量
102
审稿时长
16 weeks
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