Automatable algorithms to identify nonmedical opioid use using electronic data: A systematic review

Chelsea Canan, Jennifer M. Polinski, George Caleb Alexander, Mary K. Kowal, Troyen A. Brennan, William H. Shrank

Research output: Contribution to journalReview article

Abstract

Objective: Improved methods to identify nonmedical opioid use can help direct health care resources to individuals who need them. Automated algorithms that use large databases of electronic health care claims or records for surveillance are a potential means to achieve this goal. In this systematic review, we reviewed the utility, attempts at validation, and application of such algorithms to detect nonmedical opioid use. Materials and Methods: We searched PubMed and Embase for articles describing automatable algorithms that used electronic health care claims or records to identify patients or prescribers with likely nonmedical opioid use. We assessed algorithm development, validation, and performance characteristics and the settings where they were applied. Study variability precluded a meta-analysis. Results: Of 15 included algorithms, 10 targeted patients, 2 targeted providers, 2 targeted both, and 1 identified medications with high abuse potential. Most patient-focused algorithms (67%) used prescription drug claims and/or medical claims, with diagnosis codes of substance abuse and/or dependence as the reference standard. Eleven algorithms were developed via regression modeling. Four used natural language processing, data mining, audit analysis, or factor analysis. Discussion: Automated algorithms can facilitate population-level surveillance. However, there is no true gold standard for determining nonmedical opioid use. Users must recognize the implications of identifying false positives and, conversely, false negatives. Few algorithms have been applied in real-world settings. Conclusion: Automated algorithms may facilitate identification of patients and/or providers most likely to need more intensive screening and/or intervention for nonmedical opioid use. Additional implementation research in real-world settings would clarify their utility.

Original languageEnglish (US)
Pages (from-to)1204-1210
Number of pages7
JournalJournal of the American Medical Informatics Association
Volume24
Issue number6
DOIs
StatePublished - Nov 1 2017

Fingerprint

Opioid Analgesics
Delivery of Health Care
Substance-Related Disorders
Natural Language Processing
Population Surveillance
Data Mining
Prescription Drugs
Health Resources
PubMed
Statistical Factor Analysis
Meta-Analysis
Databases
Research

Keywords

  • Automated algorithms
  • Electronic claims data
  • Electronic health record
  • Nonmedical opioid use
  • Screening

ASJC Scopus subject areas

  • Health Informatics

Cite this

Automatable algorithms to identify nonmedical opioid use using electronic data : A systematic review. / Canan, Chelsea; Polinski, Jennifer M.; Alexander, George Caleb; Kowal, Mary K.; Brennan, Troyen A.; Shrank, William H.

In: Journal of the American Medical Informatics Association, Vol. 24, No. 6, 01.11.2017, p. 1204-1210.

Research output: Contribution to journalReview article

Canan, Chelsea ; Polinski, Jennifer M. ; Alexander, George Caleb ; Kowal, Mary K. ; Brennan, Troyen A. ; Shrank, William H. / Automatable algorithms to identify nonmedical opioid use using electronic data : A systematic review. In: Journal of the American Medical Informatics Association. 2017 ; Vol. 24, No. 6. pp. 1204-1210.
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