J Am Med Inform Assoc - Patient characteristics associated with venous thromboembolic events: a cohort study using pooled electronic health record data.

Tópicos

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Resumo

JECTIVE: To demonstrate the potential of de-identified clinical data from multiple healthcare systems using different electronic health records (EHR) to be efficiently used for very large retrospective cohort studies.MATERIALS AND METHODS: Data of 959030 patients, pooled from multiple different healthcare systems with distinct EHR, were obtained. Data were standardized and normalized using common ontologies, searchable through a HIPAA-compliant, patient de-identified web application (Explore; Explorys Inc). Patients were 26 years or older seen in multiple healthcare systems from 1999 to 2011 with data from EHR.RESULTS: Comparing obese, tall subjects with normal body mass index, short subjects, the venous thromboembolic events (VTE) OR was 1.83 (95% CI 1.76 to 1.91) for women and 1.21 (1.10 to 1.32) for men. Weight had more effect then height on VTE. Compared with Caucasian, Hispanic/Latino subjects had a much lower risk of VTE (female OR 0.47, 0.41 to 0.55; male OR 0.24, 0.20 to 0.28) and African-Americans a substantially higher risk (female OR 1.83, 1.76 to 1.91; male OR 1.58, 1.50 to 1.66). This 13-year retrospective study of almost one million patients was performed over approximately 125 h in 11 weeks, part time by the five authors.DISCUSSION: As research informatics tools develop and more clinical data become available in EHR, it is important to study and understand unique opportunities for clinical research informatics to transform the scale and resources needed to perform certain types of clinical research.CONCLUSIONS: With the right clinical research informatics tools and EHR data, some types of very large cohort studies can be completed with minimal resources.

Resumo Limpo

jectiv demonstr potenti deidentifi clinic data multipl healthcar system use differ electron health record ehr effici use larg retrospect cohort studiesmateri method data patient pool multipl differ healthcar system distinct ehr obtain data standard normal use common ontolog searchabl hipaacompli patient deidentifi web applic explor explori inc patient year older seen multipl healthcar system data ehrresult compar obes tall subject normal bodi mass index short subject venous thromboembol event vte ci women men weight effect height vte compar caucasian hispaniclatino subject much lower risk vte femal male africanamerican substanti higher risk femal male year retrospect studi almost one million patient perform approxim h week part time five authorsdiscuss research informat tool develop clinic data becom avail ehr import studi understand uniqu opportun clinic research informat transform scale resourc need perform certain type clinic researchconclus right clinic research informat tool ehr data type larg cohort studi can complet minim resourc

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