Derivation and Validation of Automated Electronic Search Strategies to Identify Pertinent Risk Factors for Postoperative Acute Lung Injury

Alsara, Anas; Warner, David O.; Guangxi Li; Herasevich, Vitaly; Gajic, Ognjen; Kor, Daryl J.
May 2011
Mayo Clinic Proceedings;May2011, Vol. 86 Issue 5, p382
Academic Journal
OBJECTIVE: To develop and validate time-efficient automated electronic search strategies for identifying preoperative risk factors for postoperative acute lung injury. PATIENTS AND METHODS: This secondary analysis of a prospective cohort study included 249 patients undergoing high-risk surgery between November 1, 2005, and August 31, 2006. Two independent data-extraction strategies were compared. The first strategy used a manual review of medical records and the second a Web- based query-building tool. Web-based searches were derived and refined In a derivation cohort of 83 patients and subsequently validated in an independent cohort of 166 patients. Agreement between the 2 search strategies was assessed with percent agreement and Cohen K statistics. RESULTS: Cohen K statistics ranged from 0.34 (95% confidence interval, 0.00-0.86) for amiodarone to 0.85 for cirrhosis (95% confidence interval, 0.57-1.00). Agreement between manual and automated electronic data extraction was almost complete for 3 variables (diabetes mellitus, cirrhosis, H2-receptor antagonists), substantial for 3 (chronIc obstructive pulmonary disease, proton pump inhibitors, statins), moderate for gastroesophageai refiux disease, and fair for 2 variables (restrictive lung disease and amiodarone). Automated electronic queries outperformed manual data collection in terms of sensitivities (median, 100% [range, 77%-100%] vs median, 87% [range, 0%-100%]). The specificities were uniformly high (≥96%) for both search strategies. CONCLUSION: Automated electronic query building is an iterative process that ultimately results in accurate, highly efficient data extraction. These strategies may be useful for both clinicians and researchers when determining the risk of time-sensitive conditions such as postoperative acute lung injury.


Related Articles

  • Use of Antireflux Medication After Antireflux Surgery. Wijnhoven, Bas P. L.; Lally, Carolyn J.; Kelly, John J.; Myers, Jennifer C.; Watson, David I. // Journal of Gastrointestinal Surgery;Mar2008, Vol. 12 Issue 3, p510 

    Introduction It is claimed that a substantial number of patients who undergo antireflux surgery use antireflux medication postoperatively. This study was aimed to determine the prevalence and underlying reasons for antireflux medication usage in patients after surgery. Materials and Methods A...

  • Intermittent and on-demand use of proton pump inhibitors in the management of symptomatic gastroesophageal reflux disease. Bardhan, Karna Dev // American Journal of Gastroenterology;Mar2003 Supplement, Vol. 98, pS40 

    The epidemic of gastroesophageal reflux disease (GERD) in industrialized nations is currently spreading to less-developed ones, with more than half of the patients having symptomatic or mild erosive GERD. The long-term management of GERD has been dominated by daily maintenance treatment with...

  • Pill-induced esophagitis caused by lansoprazole. Maekawa, Toru; Ohji, Goh; Inoue, Ryuichi; Shimoyama, Manabu; Shimada, Takao; Misaki, Fumio // Journal of Gastroenterology;2001, Vol. 36 Issue 11, p790 

    Reports on a case of pill-induced esophagitis caused by the proton pump inibitor lansoprazole in a woman. Overview of the medical history of the woman; Reasons for pill-induced esophagitis; Prevention of the occurrence of pill-induced esophagitis.

  • Esomeprazole:A clinical review. Johnson, Thomas J.; Hedge, Dennis D. // American Journal of Health-System Pharmacy;7/15/2002, Vol. 59 Issue 14, p1333 

    Examines characteristics of esomeprazole, a proton-pump inhibitor used for treating gastroesophageal reflux. Pharmacology; Pharmacodynamics; Pharmacokinetics; Clinical efficacy; Adverse effects.

  • ASCP highlights: Proton-pump inhibitors advocated for GERD. Portyansky, Elena // Drug Topics;6/7/99, Vol. 143 Issue 11, p18 

    Focuses on the advantages of utilizing proton-pump inhibitors (PPI), a class of antisecretory agents, in the treatment of gastroesophageal reflux disease (GERD). Limitations of the drugs; Drugs of choice in GERD; Potential advantages of Raberprazole, a proton-pump inhibitor. INSET: Treatment...

  • Endocinch therapy for gastro-oesophageal reflux disease: a one year prospective follow up. Mahmood, Z.; McMahon, B.P.; Arfin, Q.; Byrne, P.J.; Reynolds, J.V.; Murphy, E.M.; Weir, D.G. // Gut;Jan2003, Vol. 52 Issue 1, p34 

    Background: Gastro-oesophageal reflux disease (GORD) is, in the main, treated with either proton pump inhibitor (PPI) drugs or a Nissen fundoplication operation. Recently, BARD developed Endocinch, a device used to place sutures just below the oesophagogastric junction (OGJ) to treat GORD. Aim:...

  • Lansoprazole: In the Management of Gastroesophageal Reflux Disease in Children. Scott, L.J. // Pediatric Drugs;2003, Vol. 5 Issue 1, p57 

    â–´ Lansoprazole, a proton pump inhibitor, inactivates the H/K-ATPase pump in parietal cells, thereby suppressing basal and stimulated gastric acid secretion and increasing intragastric pH. â–´ After 8-12 weeks' treatment with lansoprazole, all children (n = 27) with esophagitis at...

  • Lansoprazole in Children: A Viewpoint by Yvan Vandenplas. Vandenplas, Y. // Pediatric Drugs;2003, Vol. 5 Issue 1, p62 

    Talks about the efficacy of lansophrazole in reducing symptoms and healing esophagitis in children. Information on proton pump inhibitors.

  • Cost effectiveness of proton pump inhibitors in gastro-oesophageal reflux disease without oesophagitis: comparison of on-demand esomeprazole with conventional omeprazole strategies. Wahlqvist, P.; Junghard, O.; Higgins, A.; Green, J.; Wahlqvist, Peter; Junghard, Ola; Higgins, Andy; Green, Jonathan // PharmacoEconomics;2002, Vol. 20 Issue 4, p267 

    Objectives: To evaluate the cost effectiveness of on-demand treatment with esomeprazole 20mg compared with two alternative omeprazole treatment strategies for the long-term management of patients with gastro-oesophageal reflux disease (GORD) without oesophagitis. Design:...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics