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Promises and pitfalls of electronic health record analysis

Farmer, R; Mathur, R; Bhaskaran, K; Eastwood, SV; Chaturvedi, N; Smeeth, L; (2018) Promises and pitfalls of electronic health record analysis. Diabetologia , 61 (6) pp. 1241-1248. 10.1007/s00125-017-4518-6. Green open access

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Abstract

Routinely collected electronic health records (EHRs) are increasingly used for research. With their use comes the opportunity for large-scale, high-quality studies that can address questions not easily answered by randomised clinical trials or classical cohort studies involving bespoke data collection. However, the use of EHRs generates challenges in terms of ensuring methodological rigour, a potential problem when studying complex chronic diseases such as diabetes. This review describes the promises and potential of EHRs in the context of diabetes research and outlines key areas for caution with examples. We consider the difficulties in identifying and classifying diabetes patients, in distinguishing between prevalent and incident cases and in dealing with the complexities of diabetes progression and treatment. We also discuss the dangers of introducing time-related biases and describe the problems of inconsistent data recording, missing data and confounding. Throughout, we provide practical recommendations for good practice in conducting EHR studies and interpreting their results.

Type: Article
Title: Promises and pitfalls of electronic health record analysis
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00125-017-4518-6
Publisher version: https://doi.org/10.1007/s00125-017-4518-6
Language: English
Additional information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Diabetes, Electronic health records, Epidemiology, Observational studies, Primary care, Review, Secondary care
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10041329
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