...

1) Loyalty Cohorts: Determination that data completeness is sufficient for creation of a Digital Twin. This is done through calculation of a “loyalty cohort” to assured that most of the care is received in the hospital systems producing the data set that is used for calculation of the twin.1,2 This step will provide the logic to exclude the conditions the individual does NOT have, as well as assure there is sufficient data to calculate the conditions that the individual does have.

2) Computational Phenotypes: We have previously found that half of patients with an ICD-9 or ICD-10 diagnosis code in the electronic health record (EHR) for Type 2 Diabetes (T2DM) do not actually have the disease. The code for T2DM thus has low "precision" for predicting the patient's true condition or "phenotype". Most diagnosis codes have this problem to varying degrees. One consequence of this is that clinical trials overestimate the number of eligible patients from the EHR. As a result, the trials have low yield in recruiting patients and are slow or unable to meet enrollment targets.