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- Title
Validation of an administrative algorithm for transgender and gender diverse persons against self-report data in electronic health records.
- Authors
Streed, Carl G; King, Dana; Grasso, Chris; Reisner, Sari L; Mayer, Kenneth H; Jasuja, Guneet K; Poteat, Tonia; Mukherjee, Monica; Shapira-Daniels, Ayelet; Cabral, Howard; Tangpricha, Vin; Paasche-Orlow, Michael K; Benjamin, Emelia J
- Abstract
Objective To adapt and validate an algorithm to ascertain transgender and gender diverse (TGD) patients within electronic health record (EHR) data. Methods Using a previously unvalidated algorithm of identifying TGD persons within administrative claims data in a multistep, hierarchical process, we validated this algorithm in an EHR data set with self-reported gender identity. Results Within an EHR data set of 52 746 adults with self-reported gender identity (gold standard) a previously unvalidated algorithm to identify TGD persons via TGD-related diagnosis and procedure codes, and gender-affirming hormone therapy prescription data had a sensitivity of 87.3% (95% confidence interval [CI] 86.4–88.2), specificity of 98.7% (95% CI 98.6–98.8), positive predictive value (PPV) of 88.7% (95% CI 87.9–89.4), and negative predictive value (NPV) of 98.5% (95% CI 98.4–98.6). The area under the curve (AUC) was 0.930 (95% CI 0.925–0.935). Steps to further categorize patients as presumably TGD men versus women based on prescription data performed well: sensitivity of 97.6%, specificity of 92.7%, PPV of 93.2%, and NPV of 97.4%. The AUC was 0.95 (95% CI 0.94–0.96). Conclusions In the absence of self-reported gender identity data, an algorithm to identify TGD patients in administrative data using TGD-related diagnosis and procedure codes, and gender-affirming hormone prescriptions performs well.
- Subjects
ELECTRONIC health records; TRANSGENDER people; GENDER; ALGORITHMS; SELF-evaluation; GENDER identity; HIERARCHICAL clustering (Cluster analysis)
- Publication
Journal of the American Medical Informatics Association, 2023, Vol 30, Issue 6, p1047
- ISSN
1067-5027
- Publication type
Article
- DOI
10.1093/jamia/ocad039