title: Clinical arrays of laboratory measures, or "clinarrays", built from an electronic health record enable disease subtyping by severity.
abstract: The severity of diseases has often been assigned by direct observation of a patient and by pathological examination after symptoms have appeared. As we move into the genomic era, the ability to predict disease severity prior to manifestation has improved dramatically due to genomic sequencing and analysis of gene expression microarrays. However, as the severity of diseases can be exacerbated by non genetic factors, the ability to predict disease severity by examining gene expression alone may be inadequate. We propose the creation of a "clinarray" to examine phenotypic expression in the form of clinical laboratory measurements. We demonstrate that the clinarray can be used to distinguish between the severities of patients with cystic fibrosis and those with Crohn's disease by applying unsupervised clustering methods that have been previously applied to microarrays.
authors.affiliation: Stanford Medical Informatics, Department of Medicine, Stanford University School of Medicine, Stanford CA 94305-5479, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Chen
authors.forename: Susan C
authors.initials: SC
authors.lastname: Weber
authors.forename: Philip S
authors.initials: PS
authors.lastname: Constantinou
authors.forename: Todd A
authors.initials: TA
authors.lastname: Ferris
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Lowe
authors.forename: Atul J
authors.initials: AJ
authors.lastname: Butte
mesh_terms: D019411:Clinical Laboratory Techniques; D003424:Crohn Disease / Q000145:classification* / Q000175:diagnosis / Q000235:genetics; D003550:Cystic Fibrosis / Q000145:classification* / Q000175:diagnosis / Q000235:genetics; D004314:Down Syndrome / Q000145:classification / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D016347:Medical Records Systems, Computerized; D010641:Phenotype; D011379:Prognosis; D012720:Severity of Illness Index