2337. Health Outcomes in Congenital Cytomegalovirus, a Systematized and Unbiased Approach in the Electronic Medical Record Era

BACKGROUND: There is limited data on the indirect and non-medical costs associated with congenital cytomegalovirus (cCMV). Attempts to predict the economic impact of disease often rely on secondary analyses of large private databases, and may not capture the full spectrum of a disease. The granularity of billing codes in the Electronic Medical Record (EMR) make it possible to track health outcomes over time, however, with over 80,000 unique codes in ICD-10, selecting the appropriate codes requires specific content knowledge and can lead to bias in categorization. The Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT)® provides physicians a tool to find specific ICD-10 on the basis of semantic terms. These terms can be used to build disease state-specific clusters of ICD-10 codes by which to study the economic impact of any disease, including this potentially devastating congenital infection. METHODS: Using a series of data parsing and processing scripts written in SAS V9.4 (Cary, NC), we extracted the diagnosis codes for 190 patients seen in our Congenital Cytomegalovirus Clinic at Texas Children’s Hospital in Houston, Texas. This data were consolidated into a relational database of clinical information. Through a second program we developed, clusters of ICD-10 codes were imputed from the SNOMED-CT® on the basis of semantic terms associated with cCMV (e.g., “hearing problem,” “developmental disability,” “neurological problem”). RESULTS: A total of 190 patients have been seen in our clinic with an ICD-10 diagnosis of CMV infection, 144 of these had cCMV, and 102 of these were born after 1/1/2008 (the inception date of our EMR). 60% of these patients were Caucasian (21% Hispanic), and 25% African American. 54 (53%) had hearing deficits, 17 (16%) had hearing aids, and 55 (54%) had developmental abnormalities. The average time (in years) to development of specific deficits are shown in Figure 1. CONCLUSION: The spectrum of disease of cCMV is broad and has been well studied in the past. The EMR gives us the potential to further study this disease in finer detail and identify rates of disease progression by mining the ICD-10 codes associated with these patients throughout time. These results should prove invaluable for generating cost-models for the economic impact of cCMV. [Image: see text] DISCLOSURES: All authors: No reported disclosures.