A Computable Phenotype Model for Classification of Men Who Have Sex With Men Within a Large Linked Database of Laboratory, Surveillance, and Administrative Healthcare Records

Peer reviewed: 
Yes, item is peer reviewed.
Scholarly level: 
Faculty/Staff
Final version published as: 

Salway, T., Butt, Z. A., Wong, S., Abdia, Y., Balshaw, R., Rich, A. J., Ablona, A., Wong, J., Grennan, T., Yu, A., Alvarez, M., Rossi, C., Gilbert, M., Krajden, M., & Janjua, N. Z. (2020). A Computable Phenotype Model for Classification of Men Who Have Sex With Men Within a Large Linked Database of Laboratory, Surveillance, and Administrative Healthcare Records. Frontiers in Digital Health, 2, 23. https://doi.org/10.3389/fdgth.2020.547324

Date created: 
2020-10-06
Identifier: 
DOI: 10.3389/fdgth.2020.547324
Keywords: 
Sexual and gender minorities
Computable phenotypes
Big data
HIV
Administrative data
Abstract: 

Background: Most public health datasets do not include sexual orientation measures, thereby limiting the availability of data to monitor health disparities, and evaluate tailored interventions. We therefore developed, validated, and applied a novel computable phenotype model to classify men who have sex with men (MSM) using multiple health datasets from British Columbia, Canada, 1990–2015.

Methods: Three case surveillance databases, a public health laboratory database, and five administrative health databases were linked and deidentified (BC Hepatitis Testers Cohort), resulting in a retrospective cohort of 727,091 adult men. Known MSM status from the three disease case surveillance databases was used to develop a multivariable model for classifying MSM in the full cohort. Models were selected using “elastic-net” (GLMNet package) in R, and a final model optimized area under the receiver operating characteristics curve. We compared characteristics of known MSM, classified MSM, and classified heterosexual men.

Findings: History of gonorrhea and syphilis diagnoses, HIV tests in the past year, history of visit to an identified gay and bisexual men's clinic, and residence in MSM-dense neighborhoods were all positively associated with being MSM. The selected model had sensitivity of 72%, specificity of 94%. Excluding those with known MSM status, a total of 85,521 men (12% of cohort) were classified as MSM.

Interpretation: Computable phenotyping is a promising approach for classification of sexual minorities and investigation of health outcomes in the absence of routinely available self-report data.

Language: 
English
Document type: 
Article
File(s): 
Sponsor(s): 
British Columbia Centre for Disease Control
Canadian Institutes of Health Research (CIHR)
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