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Development of an algorithm to identify pelvic inflammatory diseases using regional electronic hospital records: first step to assess the burden of Chlamydia trachomatis infections

Por: Quentin · E. · Escolano · S. · Verdoux · M. · Martel · P. · Fauconnier · A. · Delarocque-Astagneau · E. · Thiebaut · A. C. M.
Objectives

To develop an algorithm to identify pelvic inflammatory disease (PID) episodes based on diagnostic codes, estimate their frequency and determine the proportion related to Chlamydia trachomatis infection.

Setting

Hospital visits by women aged 18–45 years presenting with one of 31 diagnostic codes potentially associated with PID between July 2017 and December 2019 were extracted from the electronic medical record (EMR) warehouse of 39 public hospitals in the Paris area, France (EDS-APHP).

Participants

1956 patients totalling 2191 visits were included.

Design

Natural language processing (NLP) methods were developed and validated against expert reading to identify PID episodes from textual medical reports. The resulting classification served as a reference to select relevant diagnostic codes for constructing a PID identification algorithm.

Results

The final algorithm included 10 diagnostic codes, with 3 codes searched in principal or associated diagnoses and 7 codes in principal diagnosis only. The algorithm’s performance on 1732 NLP-classified visits was a 0.80 recall, a 0.74 precision and a 0.77 F1-score. On a set of 93 expert-classified visits, these performance metrics were 0.76, 0.82 and 0.79, respectively. The algorithm identified 901 PID episodes in 880 patients during the study period. C. trachomatis infection was detected in 9.9% of them.

Conclusions

Exploiting EMR data enabled the development of an algorithm with satisfactory performance for detecting PID episodes based solely on diagnostic codes. This algorithm will be useful to identify PIDs among hospitalisations from large-scale healthcare claims databases lacking medical reports, which will contribute to assess the burden of C. trachomatis infections and their complications.

Sex and the clock: Exploring sex differences in chronotype and circadian behavior among healthy older adults

by Natalie S. Pandher, Leslie Yack, Esther Li, Quentin Coppola, Kaitlin B. Cassaletto, Lea T. Grinberg, Thomas C. Neylan, Joel H. Kramer, Christine M. Walsh

This study aimed to compare subjective and objective circadian measures with a focus on sex differences and cognition in healthy older adults. A total of 126 participants (aged 65–90 years) completed the Horne & Ostberg Morning-Eveningness Questionnaire (MEQ) and the Circadian Type Inventory (CTI) to assess their morning-evening preference and four circadian traits: rigidity vs flexibility (CTI-FR) and languidity vs vigor (CTI-LV). These self-report measures were compared to actigraphy data from a sub-cohort of 63 individuals who wore wrist actigraphs for 24 hours a day over a 7-day period. Results showed that cognitively healthy older adults tend towards rigidity and vigor (on the CTI) and morningness (on the MEQ). Overall, the languid vs vigorous types and flexible vs rigid types displayed differences in MEQ scores. Sex moderated the association between the CTI-LV and MEQ with a steeper association in males than females (p = 0.012). Actigraphy data showed that males had less stable (interdaily stability, IS, p = 0.03) and more fragmented (interdaily variability, IV, p = 0.001) circadian rhythms than older females. Subjective MEQ scores were strongly predictive of acrophase time (p = 0.009) in males but not females. Using information processing speed (IPS) as a marker of cognitive function, we found that greater circadian rhythm fragmentation (IV) was linked to slower verbal IPS (p = 0.004) in males. Morning preference on the MEQ predicted faster spatial IPS in the overall sample (p 
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