Researchers have developed a reliable and low-cost way of identifying candidates for essential transgender health studies by scanning electronic medical records.
[Photo: Dr. Douglas Roblin]
A better identification method is needed because “even basic information, such as the proportion of transgender people in the general population, is not known with certainty because most available studies are based on convenience samples without an identifiable population denominator,” researchers noted in the paper “A novel method for estimating transgender status using electronic medical records”.
The results of the research — a computerized algorithm that involves scanning records for relevant diagnostic codes and keywords — were published recently in the Annals of Epidemiology. The paper’s lead author is Dr. Douglas Roblin a professor of health management and policy at the School of Public Health at Georgia State University.
The study analyzed the records of more than 800,000 enrollees of health insurance provider Kaiser Permanente Georgia. Using the algorithm, researchers identified 271 enrollees as possibly transgender, with 185 confirmed to be transgender by a panel of trained reviewers.
In reviewing the 185 people confirmed to be transgender, researchers found the probability of accurately identifying someone as transgender using keywords alone is 45 percent; 56 percent using only diagnostic codes; and 100 percent using both.
Looking only for diagnostic codes was not complete because many transgender people do not have these codes associated with their records, the research paper stated. Standard hormonal or surgical treatment codes are not necessarily specific to transgender status.
According to the paper, the study showed the new method, which involves computerized scanning of records for both diagnostic codes and keywords using standard software, “is relatively low cost, rapid, and capable of identifying persons who would have been missed by traditional approaches.”
The study’s co-authors are: Dr. Joshua Barzilay, Dennis Tolsma, Brandi Robinson, Laura Schild, Lee Cromwell, Enid Hunkeler, and Dr. Virginia P. Quinn with Kaiser Permanente; Ms. Hayley Braun, Ms. Rebecca Nash, Mr. Joseph Gerth, and Dr. Michael Goodman (study principal investigator) from Emory University; and Dr. Vin Tangpricha from Emory University’s School of Medicine and the Atlanta VA Medical Center.