title: Enhancing uterine fibroid research through utilization of biorepositories linked to electronic medical record data.
abstract: BACKGROUND
  Uterine leiomyomata (fibroids) affect up to 77% of women by menopause and account for $9.4 billion in yearly healthcare costs. Most studies rely on self-reported diagnosis, which may result in misclassification of controls since as many as 50% of cases are asymptomatic and thus undiagnosed. Our objective was to evaluate the performance and accuracy of a fibroid phenotyping algorithm constructed from electronic medical record (EMR) data, limiting to subjects with pelvic imaging.
  
  
  METHODS
  Our study population includes women from a clinical population at Vanderbilt University Medical Center (2008-2012). Analyses were restricted to women 18 years and older with at least one fibroid diagnosis confirmed by imaging for cases or at least two separate pelvic imaging procedures without a diagnosis for controls. We randomly reviewed 218 records to evaluate the accuracy of our algorithm and assess the indications for pelvic imaging. Participant characteristics and indications for imaging were compared between cases and controls in unadjusted and adjusted logistic regression analyses.
  
  
  RESULTS
  Our algorithm had a positive predictive value of 96% and negative predictive value of 98%. Increasing age (odds ratio=1.05, 95% confidence interval 1.03-1.08) and Black race (odds ratio=2.15, 95% confidence interval 1.18-3.94) were identified as risk factors for fibroids. The most common indications for imaging in both cases and controls were pain, bleeding, and reproductive factors, and the most common imaging modality was a pelvic ultrasound.
  
  
  CONCLUSIONS
  These data suggest that using biorepositories linked to EMR data is a feasible way to identify populations of imaged women that facilitate investigations of fibroid risk factors.
authors.affiliation: 1 Department of Medicine, Vanderbilt University , Nashville, TN.
authors.forename: Lani
authors.initials: L
authors.lastname: Feingold-Link
authors.forename: Todd L
authors.initials: TL
authors.lastname: Edwards
authors.forename: Sarah
authors.initials: S
authors.lastname: Jones
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
authors.forename: Digna R
authors.initials: DR
authors.lastname: Velez Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000465:Algorithms; D044383:Black People / Q000706:statistics & numerical data; D016022:Case-Control Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017699:Pelvic Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D010641:Phenotype; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000175:diagnosis*