Tamsulosin use in benign prostatic hyperplasia and risks of Parkinson's disease, Alzheimer's disease and mortality: An observational cohort study of elderly Medicare enrollees.

Purpose: To study the effects of benign prostatic hyperplasia treatments, namely: alpha-adrenergic receptor blockers, 5-alpha-reductase inhibitors and phosphodiesterase-5 inhibitors on the risk of Parkinson's disease, Alzheimer's disease and mortality.

Materials And Methods: All male Medicare enrollees aged 65 or above who were diagnosed with benign prostatic hyperplasia and received one of the study drugs between 2007-2020 were followed-up for the three outcomes. We used Cox regression analysis to assess the relative risk of each of the outcomes for each study drug compared to the most prescribed drug, tamsulosin, while controlling for demographic, socioeconomic and comorbidity factors.

Promoting interoperability between SNOMED CT and ICD-11: lessons learned from the pilot project mapping between SNOMED CT and the ICD-11 Foundation.

Objective: To explore the feasibility and challenges of mapping between SNOMED CT and the ICD-11 Foundation in both directions, SNOMED International and the World Health Organization conducted a pilot mapping project between September 2021 and August 2022.

Materials And Methods: Phase 1 mapped ICD-11 Foundation entities from the endocrine diseases chapter, excluding malignant neoplasms, to SNOMED CT. In phase 2, SNOMED CT concepts equivalent to those covered by the ICD-11 entities in phase 1 were mapped to the ICD-11 Foundation.

A risk identification model for detection of patients at risk of antidepressant discontinuation.

Purpose: Between 30 and 68% of patients prematurely discontinue their antidepressant treatment, posing significant risks to patient safety and healthcare outcomes. Online healthcare forums have the potential to offer a rich and unique source of data, revealing dimensions of antidepressant discontinuation that may not be captured by conventional data sources.

Methods: We analyzed 891 patient narratives from the online healthcare forum, "askapatient.

Two complementary AI approaches for predicting UMLS semantic group assignment: heuristic reasoning and deep learning.

Objective: Use heuristic, deep learning (DL), and hybrid AI methods to predict semantic group (SG) assignments for new UMLS Metathesaurus atoms, with target accuracy ≥95%.

Materials And Methods: We used train-test datasets from successive 2020AA-2022AB UMLS Metathesaurus releases. Our heuristic "waterfall" approach employed a sequence of 7 different SG prediction methods.

A practical strategy to use the ICD-11 for morbidity coding in the United States without a clinical modification.

Objective: The aim of this study was to derive and evaluate a practical strategy of replacing ICD-10-CM codes by ICD-11 for morbidity coding in the United States, without the creation of a Clinical Modification.

Materials And Methods: A stepwise strategy is described, using first the ICD-11 stem codes from the Mortality and Morbidity Statistics (MMS) linearization, followed by exposing Foundation entities, then adding postcoordination (with existing codes and adding new stem codes if necessary), with creating new stem codes as the last resort. The strategy was evaluated by recoding 2 samples of ICD-10-CM codes comprised of frequently used codes and all codes from the digestive diseases chapter.

Prevalence and characteristics of long COVID in elderly patients: An observational cohort study of over 2 million adults in the US.

Background: Incidence of long COVID in the elderly is difficult to estimate and can be underreported. While long COVID is sometimes considered a novel disease, many viral or bacterial infections have been known to cause prolonged illnesses. We postulate that some influenza patients might develop residual symptoms that would satisfy the diagnostic criteria for long COVID, a condition we call "long Flu.

Mapping 3 procedure coding systems to the International Classification of Health Interventions (ICHI): coverage and challenges.

Objective: To study the coverage and challenges in mapping 3 national and international procedure coding systems to the International Classification of Health Interventions (ICHI).

Materials And Methods: We identified 300 commonly used codes each from SNOMED CT, ICD-10-PCS, and CCI (Canadian Classification of Health Interventions) and mapped them to ICHI. We evaluated the level of match at the ICHI stem code and Foundation Component levels.

Sequential Mapping - A Novel Approach to Map from ICD-10-CM to ICD-11.

Background: ICD-11 will be used to report mortality statistics by WHO member countries starting in 2022. In the US, ICD-10-CM will likely continue to be used for morbidity coding for a long period of time. A map between ICD-10-CM and ICD-11 will therefore be useful for interoperability purpose between datasets coded with ICD-10-CM and ICD-11.

Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients.

Background: Maintenance drugs are used to treat chronic conditions. Several classes of maintenance drugs have attracted attention because of their potential to affect susceptibility to and severity of COVID-19.

Methods: Using claims data on 20% random sample of Part D Medicare enrollees from April to December 2020, we identified patients diagnosed with COVID-19.

Evaluation of the International Classification of Health Interventions (ICHI) in the coding of common surgical procedures.

Objective: To evaluate the International Classification of Health Interventions (ICHI) in the clinical and statistical use cases.

Materials And Methods: We identified 300 most-performed surgical procedures as represented by their display names in an electronic health record. For comparison with existing coding systems, we coded the procedures in ICHI, SNOMED CT, International Classification of Diseases (ICD)-10-PCS, and CCI (Canadian Classification of Health Interventions), using postcoordination (modification of existing codes by adding other codes), when applicable.

Feasibility of replacing the ICD-10-CM with the ICD-11 for morbidity coding: A content analysis.

Objective: The study sought to assess the feasibility of replacing the International Classification of Diseases-Tenth Revision-Clinical Modification (ICD-10-CM) with the International Classification of Diseases-11th Revision (ICD-11) for morbidity coding based on content analysis.

Materials And Methods: The most frequently used ICD-10-CM codes from each chapter covering 60% of patients were identified from Medicare claims and hospital data. Each ICD-10-CM code was recoded in the ICD-11, using postcoordination (combination of codes) if necessary.

The changing patterns of comorbidities associated with human immunodeficiency virus infection, a longitudinal retrospective cohort study of Medicare patients.

The objective of this paper is to determine the temporal trend of the association of 66 comorbidities with human immunodeficiency virus (HIV) infection status among Medicare beneficiaries from 2000 through 2016.We harvested patient level encounter claims from a 17-year long 100% sample of Medicare records. We used the chronic conditions warehouse comorbidity flags to determine HIV infection status and presence of comorbidities.

Using Medicare Data to Assess the Proarrhythmic Risk of Non-Cardiac Treatment Drugs that Prolong the QT Interval in Older Adults: An Observational Cohort Study.

Introduction: Serious cardiac arrhythmias caused by QT-prolonging drugs are difficult to predict based on physiological measurement and pre-approval clinical trials. Post-marketing surveillance and monitoring are important to generate safety data.

Objectives: To assess whether an observational study using Medicare claims data can detect the arrhythmogenic risk of QT-prolonging drugs.

The Mortality Risk of Proton Pump Inhibitors in 1.9 Million US Seniors: An Extended Cox Survival Analysis.

Background & Aims: Observational studies have linked proton pump inhibitors (PPIs) with increased risk of mortality and other safety outcomes, in contradiction with a recent PPI randomized controlled trial (RCT). Observational studies may be prone to reverse causality, where deaths are attributed to the treatment rather than the conditions that are treated (protopathic bias).

Methods: We analyzed an incident drug user cohort of 1,930,728 elderly Medicare fee-for-service beneficiaries to evaluate the PPI-associated risk of death with a Cox regression analysis with time-varying covariates and propensity score adjustments.

Use of word and graph embedding to measure semantic relatedness between Unified Medical Language System concepts.

Objective: The study sought to explore the use of deep learning techniques to measure the semantic relatedness between Unified Medical Language System (UMLS) concepts.

Materials And Methods: Concept sentence embeddings were generated for UMLS concepts by applying the word embedding models BioWordVec and various flavors of BERT to concept sentences formed by concatenating UMLS terms. Graph embeddings were generated by the graph convolutional networks and 4 knowledge graph embedding models, using graphs built from UMLS hierarchical relations.

The new International Classification of Diseases 11th edition: a comparative analysis with ICD-10 and ICD-10-CM.

Objective: To study the newly adopted International Classification of Diseases 11th revision (ICD-11) and compare it to the International Classification of Diseases 10th revision (ICD-10) and International Classification of Diseases 10th revision-Clinical Modification (ICD-10-CM).

Materials And Methods: : Data files and maps were downloaded from the World Health Organization (WHO) website and through the application programming interfaces. A round trip method based on the WHO maps was used to identify equivalent codes between ICD-10 and ICD-11, which were validated by limited manual review.

Sharing of Individual Participant Data from Clinical Trials: General Comparison and HIV Use Case.

Sharing of individual participant data is encouraged by the International Committee of Medical Journal Editors. We analyzed clinical trial registry data from ClinicalTrials.gov (CTG) and determined the proportion of trials sharing de-identified Individual Participant Data (IPD).

The Use of Inter-terminology Maps for the Creation and Maintenance of Value Sets.

Value sets are essential in activities such as electronic clinical quality measures (eCQM) and patient cohort definition. Creation and maintenance of value sets is labor intensive and error prone. Our method aims to use existing inter-terminology maps to improve the quality of value sets that are defined in more than one terminology.

Evaluation of Research Accessibility and Data Elements of HIV Registries.

Background: Patient registries represent a long-term data collection system that is a platform for performing multiple research studies to generate real-world evidence. Many of these registries use common data elements (CDEs) and link data from Electronic Health Records.

Objective: This study evaluated HIV registry features that contribute to the registry's usability for retrospective analysis of existing registry data or new prospective interventional studies.

Map-Assisted Generation of Procedure and Intervention Encoding (Magpie): An Innovative Approach for ICD-10-PCS Coding.

ICD-10-PCS coding is challenging because of the large number of codes, non-intuitive terms and paucity of the ICD-10-PCS index. We previously repurposed the richer ICD-9-CM procedure index for ICD-10-PCS coding. We have developed the MAGPIE tool based on the repurposed ICD-9-CM index with other lexical and mapping resources.

The PsyTAR dataset: From patients generated narratives to a corpus of adverse drug events and effectiveness of psychiatric medications.

The "Psychiatric Treatment Adverse Reactions" (PsyTAR) dataset contains patients' expression of effectiveness and adverse drug events associated with psychiatric medications. The PsyTAR was generated in four phases. In the first phase, a sample of 891 drugs reviews posted by patients on an online healthcare forum, "askapatient.

Using SNOMED CT-encoded problems to improve ICD-10-CM coding-A randomized controlled experiment.

Objective: Clinical problems in the Electronic Health Record that are encoded in SNOMED CT can be translated into ICD-10-CM codes through the NLM's SNOMED CT to ICD-10-CM map (NLM Map). This study evaluates the potential benefits of using the map-generated codes to assist manual ICD-10-CM coding.

Methods: De-identified clinic notes taken by the physician during an outpatient encounter were made available on a secure web server and randomly assigned for coding by professional coders with usual coding or map-assisted coding.

Re-purposing the ICD-9-CM Procedures Index for Coding in ICD-10-PCS and SNOMED CT.

Compared to the ICD-10-PCS index, the ICD-9-CM Procedure (ICD9V3) Index is richer and contains more clinician-friendly terms including abbreviations and eponyms. We re-purposed the ICD9V3 index by mapping the index terms to SNOMED CT and the ICD-9-CM codes to ICD-10-PCS codes through the General Equivalent Mappings. The re-purposed index outperformed the ICD-10-PCS index in the retrieval of ICD-10-PCS codes using a list of commonly used procedure names, with significantly higher recall, precision and F-score.

A systematic approach for developing a corpus of patient reported adverse drug events: A case study for SSRI and SNRI medications.

"Psychiatric Treatment Adverse Reactions" (PsyTAR) corpus is an annotated corpus that has been developed using patients narrative data for psychiatric medications, particularly SSRIs (Selective Serotonin Reuptake Inhibitor) and SNRIs (Serotonin Norepinephrine Reuptake Inhibitor) medications. This corpus consists of three main components: sentence classification, entity identification, and entity normalization. We split the review posts into sentences and labeled them for presence of adverse drug reactions (ADRs) (2168 sentences), withdrawal symptoms (WDs) (438 sentences), sign/symptoms/illness (SSIs) (789 sentences), drug indications (517), drug effectiveness (EF) (1087 sentences), and drug infectiveness (INF) (337 sentences).