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Table 2 Reason for misclassification between antimicrobial prophylaxis algorithm and manual reviewa

From: Novel methodology to measure pre-procedure antimicrobial prophylaxis: integrating text searches with structured data from the Veterans Health Administration’s electronic medical record

Reasons

Algorithm Development

(n procedures)

Algorithm Validation

(n procedures)

False +

False -

False +

False -

Documentation drug was administered, but no name used in EMR or order

 

27

  

Documentation of drug name in EMR and order but placed > 7 days pre-procedure

 

4

  

Clinician note entered into CDW with date ≥1 day post-procedure

 

3

  

Documentation of drug name composed on paper and scanned into CDW

 

1

 

39

Incorrect procedure date in CDW

 

1

 

1

Incorrect CPT code in CDW

 

1

  

No documentation in EMR or CDW

 

2

  

Antimicrobials administered post-procedure

21

 

2

 

No documentation of drug type in EMR or CDW

2

   

Patient on antimicrobials for unrelated reason

3

   

Antimicrobials used as part of a flush or wash during the procedure, but not given systemically

5

   

Total

27b

39

2

40

  1. aManually collected data on antimicrobial prophylaxis from 2102 procedures in the CART-EP dataset (used for algorithm development over two rounds), and 100 manually reviewed cases from the FY16–17 national sample of cardiac device procedures (used for algorithm validation)
  2. bSome cases were false positives for multiple reasons