Feasibility of Large-Scale Identification of Sessile Serrated Polyp Patients Using Electronic Records: A Utah Study.
The serrated pathway accounts for 15-25% of sporadic colorectal cancer (CRC). In our study, we sought to accurately characterize sessile serrated polyps (SSP) in a population by electronically interrogating colonoscopy patients' endoscopy and pathology reports using a rules-based text search of pre-defined SSP-related terms. To this aim, we compared a sample of putative SSP and hyperplastic polyps (HP) using our algorithm to a determination of SSP or HP by pathologist and molecular examination to determine the feasibility of large-scale identification of SSP in electronic medical records.



In 23,990 endoscopy reports from colonoscopies with pathology performed at a University of Utah Healthcare facility in 2000-2012, we identified serrated lesions and categorized each as putative SSP or HP using a text search algorithm. We obtained 93 tissue samples for histologic and molecular analysis.



Serrated polyps were categorized as putative SSP (N = 920) and putative HP (N = 7159) by text search algorithm. Histologic examination of 93 samples identified 37 SSP, 11 probable SSP, and 45 HP. Of 26 putative SSP, 25 were SSP/probable SSP (96%) by histology. Of 67 putative HP, 44 were HP (66%) by histology. Reducing size criterion from ≥1 to ≥5 mm in the search algorithm caused improved sensitivity (77.1%) without decline in specificity (97.8%).



A simple rules-based search to identify SSP provides "proof of principle" that SSP can be identified in a large electronic record set. Pilot data indicate defining large, right-sided polyps as ≥5 mm provides adequate sensitivity to detect SSP from electronic records while maintaining high specificity.
Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA. kajsa.affolter@hsc.utah.edu.|Department of Anatomic Pathology, ARUP Laboratories, 500 S Chipeta Way, Salt Lake City, UT, 84108, USA. kajsa.affolter@hsc.utah.edu.|Department of Pathology, University of Utah Health Sciences Center, Huntsman Cancer Hospital, RM N3100, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA. kajsa.affolter@hsc.utah.edu.
Kajsa
0000-0002-1703-0535
K
Affolter
Department of Oncological Sciences, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA.|Department of Pathology, University of Utah Health Sciences Center, Huntsman Cancer Hospital, RM N3100, 1950 Circle of Hope, Salt Lake City, UT, 84112, USA.
Keith
K
Gligorich
Department of Internal Medicine, Gastroenterology, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA.|Department of Endoscopy, University of Utah Health Sciences Center, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
Niloy Jewel
NJ
Samadder
Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA.|Department of Anatomic Pathology, ARUP Laboratories, 500 S Chipeta Way, Salt Lake City, UT, 84108, USA.
Wade S
WS
Samowitz
Department of Internal Medicine, Gastroenterology, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA.|Utah Population Database, 675 Arapeen Drive, Room 210 (Suite 200), Salt Lake City, UT, 84112, USA.
Karen
K
Curtin
D000236:Adenoma / Q000145:classification / Q000473:pathology*; D000368:Aged; D000465:Algorithms; D003111:Colonic Polyps / Q000145:classification / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000145:classification / Q000473:pathology*; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000032:analysis*; D057225:Data Mining; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012907:Smoking; D047368:Tumor Burden; D014589:Utah
D004273:DNA, Neoplasm
Colonoscopy; Receiver operating characteristic curve; Sessile serrated adenoma/polyp; Text mining