eprintid: 10205636 rev_number: 6 eprint_status: archive userid: 699 dir: disk0/10/20/56/36 datestamp: 2025-03-05 14:33:28 lastmod: 2025-03-05 14:33:28 status_changed: 2025-03-05 14:33:28 type: article metadata_visibility: show sword_depositor: 699 creators_name: Moore, Elizabeth creators_name: Stone, Philip creators_name: Alizadeh, Ayda creators_name: Sangha, Jaspreet creators_name: Das, Saranya creators_name: Arshanapalli, Shraddha creators_name: Quint, Jennifer K title: Validation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Recording in Electronic Health Records: A Systematic Review ispublished: inpress divisions: UCL divisions: B02 divisions: D12 divisions: G20 keywords: acute exacerbation of COPD, AECOPD, COPD, electronic health records note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. abstract: OBJECTIVE: Acute exacerbations of COPD (AECOPD) can have severe impacts on patients with the disease and a heavy burden on healthcare resources. Electronic health records (EHRs) are a valuable resource for identifying cases of AECOPD and research. Studies have attempted to validate case definitions of AECOPD and this review aimed to summarise validated AECOPD definitions in EHRs, and to provide guidance on the best algorithms to use to ensure accurate cohorts of AECOPD cases are available for researchers using EHRs. METHODS: MEDLINE and Embase were searched and studies that met the inclusion criteria were reviewed by ≥2 reviewers. Data extracted included the algorithms used to identify AECOPD, the reference standards used to compare against the algorithm, and measures of validity. The risk of bias was assessed using QUADAS-2 adapted for this review. RESULTS: Out of 2,784 studies found by the search strategy, 12 met the inclusion criteria. The clinical terminology used to build algorithms to detect AECOPD included codes from the International Statistical Classification of Diseases and Related Health Problems (ICD) 9th and 10th editions (ICD-9 and ICD-10), along with Read codes from UK general practices. AECOPD can be identified within EHRs using validated definitions, however the validity of AECOPD definitions vary considerably depending on the algorithm used and the settings they are applied in. CONCLUSION: Although there are validated definitions that can be used to identify AECOPD, there is no clear consensus on which provides the highest validity or the most sensitive and specific definition to use. date: 2025-02-05 date_type: published publisher: COPD Foundation official_url: https://doi.org/10.15326/jcopdf.2024.0577 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2359095 doi: 10.15326/jcopdf.2024.0577 medium: Print-Electronic lyricists_name: Stone, Philip lyricists_id: PSTON34 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Chronic Obstructive Pulmonary Diseases event_location: United States citation: Moore, Elizabeth; Stone, Philip; Alizadeh, Ayda; Sangha, Jaspreet; Das, Saranya; Arshanapalli, Shraddha; Quint, Jennifer K; (2025) Validation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Recording in Electronic Health Records: A Systematic Review. Chronic Obstructive Pulmonary Diseases 10.15326/jcopdf.2024.0577 <https://doi.org/10.15326/jcopdf.2024.0577>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205636/1/JCOPDF-2024-0577-InPress.pdf