S73 Development of an Automated Algorithm to Detect Emergency Presentations Among Pancreatic Cancer Patients

• Published in: The American journal of gastroenterology Vol. 118; no. 10S; pp. S60 - S61
• Main Authors: Kapadia, Paarth, Ali, Basim, Zimolzak, Andrew, Singh, Hardeep, Khalaf, Natalia
• Format: Journal Article
• Language: English
• Published: New York Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01-10-2023
• Subjects: Algorithms; Automation; Confidence intervals; Emergency medical care; Ethnicity; Hispanic people; Medical diagnosis; Pancreatic cancer; Patients; Regression analysis; United States > US
• ISSN: 0002-9270; 1572-0241
• DOI: 10.14309/01.ajg.0000949932.14651.8d

Pancreatic cancer has among the highest rates of EPs in European studies; however, such EPs remain underexplored in the U.S. In this study, we developed an automated algorithm to detect pancreatic cancer EPs in the national Veterans Affairs (VA) healthcare system and investigated patient characteristics and survival associated with EPs. Results: The algorithm had a positive predictive value of 89.5%, negative predictive value of 80.5%, sensitivity of 90.6%, and specificity of 78.5% for identifying EPs among pancreatic cancer patients in the local VA dataset (N=243, 66.7% EP rate). Multivariable Associations Between Patient Characteristics and Outcome (Diagnosis of Pancreatic Cancer via Emergency Presentation) Patient Characteristics Adjusted Odds Ratio (95% Confidence Interval) P-Value Age 0.99 (0.99-0.99) < 0.01 Sex: Male -reference- Sex: Female 1.06 (0.83-1.35) 0.65 Race/Ethnicity: Non-Hispanic White -reference- Race/Ethnicity: Non-Hispanic Black 1.16 (1.04-1.29) 0.01 Race/Ethnicity: Hispanic 1.16 (0.96-1.39) 0.12 Race/Ethnicity: Asian 1.1 (0.51-2.36) 0.81 Race/Ethnicity: Pacific Islander 0.97 (0.59-1.6) 0.9 Race/Ethnicity: American Indian/Alaskan Native 1.02 (0.64-1.64) 0.93 Race/Ethnicity: Other/Unknown 0.88 (0.76-1.02) 0.1 Elixhauser Comorbidity Index 1.02 (1.01-1.02) < 0.01 Patient Home Address: Metropolitan* Area -reference- Patient Home Address: Micropolitan* Area 0.81 (0.71-0.92) < 0.01 Patient Home Address: Small Town* Area 0.75 (0.64-0.88) < 0.01 Patient Home Address: Rural* Area 0.81 (0.67-0.97) 0.03 Cancer Stage: I -reference- Cancer Stage: II 1.42 (1.25-1.61) < 0.01 Cancer Stage: III 1.44 (1.23-1.67) < 0.01 Cancer Stage: IV 1.85 (1.65-2.06) < 0.01 *Patient home address geographic designations derived from the United States Department of Agriculture's Rural-Urban Commuting Area (RUCA) codes.