What every reader should know about studies using electronic health record data but may be afraid to ask

Kohane IS, Aronow BJ, Avillach P, Beaulieu-Jones BK, Bellazzi R, Bradford RL, Brat GA, Cannataro M, Cimino JJ, Garcia-Barrio N, Gehlenborg N, Ghassemi M, Gutierrez-Sacristan A, Hanauer DA, Holmes JH, Hong C, Klann JG, Loh NHW, Luo Y, Mandl KD, Daniar M, Moore JH, Murphy SN, Neuraz A, Ngiam KY, Omenn GS, Palmer N, Patel LP, Pedrera-Jimenez M, Sliz P, South AM, Tan ALM, Taylor DM, Taylor BW, Torti C, Vallejos AK, Wagholikar KB, Weber GM, Cai T (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Book Volume: 23

Article Number: e22219

Journal Issue: 3

DOI: 10.2196/22219

Abstract

Coincident with the tsunami of COVID-19-related publications, there has been a surge of studies using real-world data, including those obtained from the electronic health record (EHR). Unfortunately, several of these high-profile publications were retracted because of concerns regarding the soundness and quality of the studies and the EHR data they purported to analyze. These retractions highlight that although a small community of EHR informatics experts can readily identify strengths and flaws in EHR-derived studies, many medical editorial teams and otherwise sophisticated medical readers lack the framework to fully critically appraise these studies. In addition, conventional statistical analyses cannot overcome the need for an understanding of the opportunities and limitations of EHR-derived studies. We distill here from the broader informatics literature six key considerations that are crucial for appraising studies utilizing EHR data: Data completeness, data collection and handling (eg, transformation), data type (ie, codified, textual), robustness of methods against EHR variability (within and across institutions, countries, and time), transparency of data and analytic code, and the multidisciplinary approach. These considerations will inform researchers, clinicians, and other stakeholders as to the recommended best practices in reviewing manuscripts, grants, and other outputs from EHR-data derived studies, and thereby promote and foster rigor, quality, and reliability of this rapidly growing field.

Involved external institutions

Harvard University United States (USA) (US) University of Cincinnati United States (USA) (US) Università degli Studi di Pavia Italy (IT) University of North Carolina at Chapel Hill United States (USA) (US) Magna Græcia University of Catanzaro / Università degli studi Magna Græcia di Catanzaro Italy (IT) University of Alabama at Birmingham (UAB) United States (USA) (US) Hospital Universitario 12 de Octubre Spain (ES) University of Toronto Canada (CA) University of Michigan United States (USA) (US) University of Pennsylvania United States (USA) (US) National University Health System (NUHS) Singapore (SG) Northwestern University United States (USA) (US) Boston Children's Hospital United States (USA) (US) Hôpital Necker-Enfants malades France (FR) University of Kansas (KU) United States (USA) (US) Wake Forest University United States (USA) (US) Children's Hospital of Philadelphia United States (USA) (US) Medical College of Wisconsin (MCW) United States (USA) (US)

How to cite

APA:

Kohane, I.S., Aronow, B.J., Avillach, P., Beaulieu-Jones, B.K., Bellazzi, R., Bradford, R.L.,... Cai, T. (2021). What every reader should know about studies using electronic health record data but may be afraid to ask. Journal of Medical Internet Research, 23(3). https://doi.org/10.2196/22219

MLA:

Kohane, Isaac S., et al. "What every reader should know about studies using electronic health record data but may be afraid to ask." Journal of Medical Internet Research 23.3 (2021).

BibTeX: Download