title: Validation of the Use of Electronic Health Records for Classification of ADHD Status.
abstract: To validate an electronic health record (EHR)-based algorithm to classify ADHD status of pediatric patients.
  
  
  
  As part of an applied study, we identified all primary care patients of The Children's Hospital of Philadelphia [CHOP] health care network who were born 1987-1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of "314.x" at a clinical visit or on a list of known conditions. We manually reviewed EHRs for ADHD patients ( n = 2,030) and a random weighted sample of non-ADHD patients ( n = 807 of 13,579) to confirm the presence or absence of ADHD.
  
  
  
  Depending on assumptions for inconclusive cases, sensitivity ranged from 0.96 to 0.97 (95% confidence interval [CI] = [0.95, 0.97]), specificity from 0.98 to 0.99 [0.97, 0.99], and positive predictive value from 0.83 to 0.98 [0.81, 0.99].
  
  
  
  EHR-based diagnostic codes can accurately classify ADHD status among pediatric patients and can be used by large-scale epidemiologic and clinical studies with high sensitivity and specificity.
authors.affiliation: 1 The Children's Hospital of Philadelphia, PA, USA.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Gruschow
authors.affiliation: 1 The Children's Hospital of Philadelphia, PA, USA.|2 University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Yerys
authors.affiliation: 1 The Children's Hospital of Philadelphia, PA, USA.|2 University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Power
authors.affiliation: 1 The Children's Hospital of Philadelphia, PA, USA.|2 University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Durbin
authors.affiliation: 1 The Children's Hospital of Philadelphia, PA, USA.
authors.forename: Allison E
authors.initials: AE
authors.lastname: Curry
keywords: accuracy; adolescents; attention deficit disorder; medical records; sensitivity