Liang Liang1, Nicole Kim1, Jue Hou1, Tianrun Cai2, Kumar Dahal2, Chen Lin3, Sean Finan3, Guergana Savovoa3, Mattia Rosso4, Mariann Polgar-Tucsanyi4, Howard Weiner4, Tanuja Chitnis4, Tianxi Cai5, Zongqi Xia6. 1. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America. 2. Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States of America. 3. Clinical Natural Language Processing Program, Boston Children's Hospital, Boston, MA, United States of America. 4. Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States of America. 5. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States of America. 6. Department of Neurology and Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America. Electronic address: zxia1@post.harvard.edu.
Abstract
BACKGROUND: Long-term data on multiple sclerosis (MS) inflammatory disease activity are limited. We examined electronic health records (EHR) indicators of disease activity in people with MS. METHODS: We analyzed prospectively collected research registry data and linked EHR data in a clinic-based cohort from 2000 to 2016. We used the trend of the yearly incident relapse rate from the registry data as benchmark. We then calculated the temporal trends of potentially relevant EHR measures, including mean count of the MS diagnostic code, mentions of MS-related concepts, MS-related health utilizations and selected prescriptions. RESULTS: 1,555 MS patients had both registry and EHR data. Between 2000 and 2016, the registry data showed a declining trend in the yearly incident relapse rate, parallel to an increasing trend of DMT usage. Among the EHR measures, covariate-adjusted frequency of diagnostic code of MS, procedure codes of MS-related imaging studies and emergency room visits, and electronic prescription for steroids declined over time, mirroring the temporal trend of the benchmark yearly incident relapse rate. CONCLUSION: This study highlights EHR indicators of MS relapse that could enable large-scale examination of long-term disease activities or inform individual patient monitoring in clinical settings where EHR data are available.
BACKGROUND: Long-term data on multiple sclerosis (MS) inflammatory disease activity are limited. We examined electronic health records (EHR) indicators of disease activity in people with MS. METHODS: We analyzed prospectively collected research registry data and linked EHR data in a clinic-based cohort from 2000 to 2016. We used the trend of the yearly incident relapse rate from the registry data as benchmark. We then calculated the temporal trends of potentially relevant EHR measures, including mean count of the MS diagnostic code, mentions of MS-related concepts, MS-related health utilizations and selected prescriptions. RESULTS: 1,555 MS patients had both registry and EHR data. Between 2000 and 2016, the registry data showed a declining trend in the yearly incident relapse rate, parallel to an increasing trend of DMT usage. Among the EHR measures, covariate-adjusted frequency of diagnostic code of MS, procedure codes of MS-related imaging studies and emergency room visits, and electronic prescription for steroids declined over time, mirroring the temporal trend of the benchmark yearly incident relapse rate. CONCLUSION: This study highlights EHR indicators of MS relapse that could enable large-scale examination of long-term disease activities or inform individual patient monitoring in clinical settings where EHR data are available.
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