Center for Injury Research and Prevention

Validation of the Use of Electronic Health Records for Classification of ADHD Status

TitleValidation of the Use of Electronic Health Records for Classification of ADHD Status
Publication TypeJournal Article
Year of Publication2016
AuthorsCurry AE, Durbin D, Gruschow S, Power TJ, Yerys B
JournalJournal of Attention Disorders
Issueepub ahead of print
Date Published10/2016
Type of Articlejournal
Keywordsaccuracy, adolescents, attention deficit disorder, Medical Records, sensitivity

Objective: To validate an electronic health record (EHR)–based algorithm to classify ADHD status of pediatric patients. Method: As part of an applied study, we identified all primary care patients of The Children’s Hospital of Philadelphia [CHOP] health care network who were born 1987-1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of “314.x” at a clinical visit or on a list of known conditions. We manually reviewed EHRs for ADHD patients (n = 2,030) and a random weighted sample of non-ADHD patients (n = 807 of 13,579) to confirm the presence or absence of ADHD. Results: Depending on assumptions for inconclusive cases, sensitivity ranged from 0.96 to 0.97 (95% confidence interval [CI] = [0.95, 0.97]), specificity from 0.98 to 0.99 [0.97, 0.99], and positive predictive value from 0.83 to 0.98 [0.81, 0.99]. Conclusion: EHR-based diagnostic codes can accurately classify ADHD status among pediatric patients and can be used by large-scale epidemiologic and clinical studies with high sensitivity and specificity.