Table 2 Final operational definition of 19 asthma-associated infectious and inflammatory comorbidities
Infectious diseases | EHR sources |
|---|---|
1. Invasive Bacterial Infection: A AND B A: Any pathogenic bacteria isolated from normally sterile body fluid including blood, CSF, pleural fluid, pericardia fluid, peritoneal fluid, or synovial fluid, B. Any physician diagnosis of sepsis, bacteremia, meningitis, encephalitis, mastoiditis, brain abscess, pneumonia, cellulitis, osteomyelitis, septic arthritis, pleuritis, or pericarditis, and pyelonephritis documented in medical records related to bacteria source cultured | Lab result, Clinical note (Diagnosis) |
2. Frequent Streptococcus Pyogenes Upper Respiratory Infection: A AND B AND C A. Physician diagnosis of sore throat, pharyngitis and tonsillitis B. Throat swab test (rapid antigen detection test (RADT), Streptococcus pyogenes culture, or PCR [Polymerase chain reaction]) C. 3 or more episodes within 12Â months | Lab result, Clinical note (Diagnosis) |
3. Pneumonia: A AND (B AND/OR C) A. Physician diagnosis of pneumonia B. Compatible exam findings (fever >  = 100.5◦F AND cough AND rale or crackle or crepitation) C. Chest radiograph finding suggesting pneumonia (consolidation, lobar pneumonia, and infiltrates) | Clinical note (Diagnosis, History of present illness, Physical examination), Chest X-ray finding |
4. Recurrent or Persistent Otitis Media CPT (Current Procedural Terminology) codes for tympanostomy tube placement (surrogate marker for either persistent or recurrent otitis media during childhood) | CPT codes |
5. Recurrent or Persistent Infectious Sinusitis: A AND (B AND/OR C) A. 4 or more episodes of Physician diagnosis of sinusitis documented with antibiotic prescription over 12Â months B. Sinus CT findings suggestive of sinus opacification or air/fluid level C. Sinus surgery | Clinical note (Diagnosis), Computerized Tomography (CT) finding, Operational note |
6. Bordetella Pertussis Polymerase Chain Reaction (PCR) + for Bordetella pertussis from the upper respiratory tract | Lab result |
7. Breakthrough Varicella Infection: A AND/OR B A. Physician diagnosis of Varicella (chickenpox) B. Positive lab result (PCR +) of varicella infection occurred 42 days after varicella vaccination (excluding non-vaccinated children) | Lab result, Clinical note (Diagnosis) |
8. Zoster (Shingles): A AND (B AND/OR C) A. Physician diagnosis of zoster B. Positive lab result (PCR +) C. Anti-viral medication for Varicella zoster virus (e.g. acyclovir) | Lab result, Clinical note, Medication prescription |
9. Urinary Tract Infection (UTI): Urinary test results supporting the evidence of UTI as follows; A AND B A. Recovery of any organisms from a suprapubic specimen, at least 50 000 colony-forming units per milliliter (CFUs/mL) from a catheterized specimen, or at least 100 000 CFUs/mL from a clean-catch specimen B. At least 10 white blood cells per microliter from an unspun specimen examined using a counting chamber or at least 5 white blood cells per high power field from a centrifuged specimen | Lab result |
10. Skin Fungal Infection: A AND/OR B A. Physician diagnosis of any skin fungal infection with antifungal therapy B. Fungal culture or fungal smear positive | Lab result, Clinical note (Diagnosis) |
11. Clinically Significant Viral Infection confirmed by lab: A AND B A. A physician diagnosis of respiratory or gastrointestinal viral infection B. PCR + or culture + test for respiratory or gastrointestinal virus infection | Lab result, Clinical note (Diagnosis) |
Inflammatory diseases | Â |
12. Celiac Disease (CD): A AND ([B AND C] AND/OR [D AND E]) A. Physician diagnosis of Celiac disease documented at least once by gastroenterologist B. Positive CD serology markers (TTG lgA > 10 higher than normal) C. EMA positivity or DGA positively D. TTG IgA positivity E. Histologic findings (increased in IEL, villous atrophy, crypts hyperplasia) | Lab result, Clinical note (Diagnosis), Endoscopy finding |
13. Kawasaki Disease Physician diagnosis of Kawasaki disease documented at least once by infectious disease, cardiology, or rheumatology specialist | Clinical note (Diagnosis) |
14. Appendicitis: A OR (B AND C) A. Surgeon's diagnosis in operation note (excluding incidental appendectomy or normal appendix) B. Physician diagnosis of appendicitis C. Imaging study suggestive of appendicitis | Clinical note (Diagnosis), Operational note, CT or Ultrasound finding |
15. Autoimmune Thyroiditis Physician diagnosis of autoimmune thyroiditis documented at least twice in a 6Â month or greater span including endocrinologist's diagnosis at least once | Clinical note (Diagnosis) |
16. Diabetes Type 1 Physician diagnosis of Type 1 Diabetes documented at least twice in a 6Â month or greater span including endocrinologist's diagnosis at least once | Clinical note (Diagnosis) |
17. Diabetes Type 2 Physician diagnosis of Type 2 Diabetes documented at least twice in a 6Â month or greater span including endocrinologist's diagnosis at least once | Clinical note (Diagnosis) |
18. Inflammatory Bowel Disease (IBD; Crohn's Disease (CD), Ulcerative Colitis (UC)) Physician diagnosis of IBD, CD, or UC documented at least twice in a 6Â month or greater span including gastroenterologist's diagnosis at least once | Clinical note (Diagnosis) |
19. Juvenile Rheumatoid Arthritis (JRA), Juvenile idiopathic Arthritis (JIA), or Rheumatoid Arthritis (RA) Physician diagnosis of JRA, JIA, and RA documented at least twice in a 6Â month or greater span including a rheumatologist's diagnosis at least once | Clinical note (Diagnosis) |