Dataset Information

Predicting Life Expectancy to Target Cancer Screening Using Electronic Health Record Clinical Data.

ABSTRACT:

Background

Guidelines recommend breast and colorectal cancer screening for older adults with a life expectancy >10 years. Most mortality indexes require clinician data entry, presenting a barrier for routine use in care. Electronic health records (EHR) are a rich clinical data source that could be used to create individualized life expectancy predictions to identify patients for cancer screening without data entry.

Objective

To develop and internally validate a life expectancy calculator from structured EHR data.

Design

Retrospective cohort study using national Veteran's Affairs (VA) EHR databases.

Patients

Veterans aged 50+ with a primary care visit during 2005.

Main measures

We assessed demographics, diseases, medications, laboratory results, healthcare utilization, and vital signs 1 year prior to the index visit. Mortality follow-up was complete through 2017. Using the development cohort (80% sample), we used LASSO Cox regression to select ~100 predictors from 913 EHR data elements. In the validation cohort (remaining 20% sample), we calculated the integrated area under the curve (iAUC) and evaluated calibration.

Key results

In 3,705,122 patients, the mean age was 68 years and the majority were male (97%) and white (85%); nearly half (49%) died. The life expectancy calculator included 93 predictors; age and gender most strongly contributed to discrimination; diseases also contributed significantly while vital signs were negligible. The iAUC was 0.816 (95% confidence interval, 0.815, 0.817) with good calibration.

Conclusions

We developed a life expectancy calculator using VA EHR data with excellent discrimination and calibration. Automated life expectancy prediction using EHR data may improve guideline-concordant breast and colorectal cancer screening by identifying patients with a life expectancy >10 years.

SUBMITTER: Lee AK

PROVIDER: S-EPMC8858374 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predicting Life Expectancy to Target Cancer Screening Using Electronic Health Record Clinical Data.

Lee Alexandra K AK Jing Bocheng B Jeon Sun Y SY Boscardin W John WJ Lee Sei J SJ

Journal of general internal medicine 20210729 3

<h4>Background</h4>Guidelines recommend breast and colorectal cancer screening for older adults with a life expectancy >10 years. Most mortality indexes require clinician data entry, presenting a barrier for routine use in care. Electronic health records (EHR) are a rich clinical data source that could be used to create individualized life expectancy predictions to identify patients for cancer screening without data entry.<h4>Objective</h4>To develop and internally validate a life expectancy cal ...[more]

PMID: 34327653

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Dataset Information

Predicting Life Expectancy to Target Cancer Screening Using Electronic Health Record Clinical Data.

Background

Objective

Design

Patients

Main measures

Key results

Conclusions

Publications

Predicting Life Expectancy to Target Cancer Screening Using Electronic Health Record Clinical Data.

Similar Datasets

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