"Big data" and the electronic health record.
"Big data" and the electronic health record.
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DOI：
10.15265/iy-2014-0003
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发表时间：
2014-08-15
影响因子：
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通讯作者：
Ohno-Machado, L
中科院分区：
文献类型：
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作者：
Ross, M K;Wei, W;Ohno-Machado, L
目标：电子健康记录（EHR）系统的实施继续扩大。大量的患者就诊导致了大量的存储数据。几十年来，将临床数据转化为知识以改善患者护理一直是生物医学信息学专业人员的目标，这项工作现在越来越多地在我们的领域之外得到认可。在回顾过去三年的文献时，我们重点关注电子病历系统背景下的“大数据”，并报告了一些如何将数据的二次使用付诸实践的例子。方法：检索PubMed数据库2011年1月1日至2013年11月1日的文献。我们以“大数据”和电子病历相关的关键词开始搜索。我们确定了相关的文章，并从检索到的文章中添加了其他关键字。基于新的关键字，更多的文章被检索到，我们使用预定义的包含和排除标准手动缩小了范围。结果：我们的最终综述包括数据挖掘（药物警戒、表型、自然语言处理）、数据应用和集成（临床决策支持、个人监测、社交媒体）以及隐私和安全等主题的文章。结论：全球越来越多地采用电子病历系统，使得获取大量临床数据成为可能。讨论“大数据”主题的文章越来越多，与这些文章相关的概念也各不相同。下一步是将医疗保健大数据转化为可操作的知识。
OBJECTIVES: Implementation of Electronic Health Record (EHR) systems continues to expand. The massive number of patient encounters results in high amounts of stored data. Transforming clinical data into knowledge to improve patient care has been the goal of biomedical informatics professionals for many decades, and this work is now increasingly recognized outside our field. In reviewing the literature for the past three years, we focus on "big data" in the context of EHR systems and we report on some examples of how secondary use of data has been put into practice.METHODS: We searched PubMed database for articles from January 1, 2011 to November 1, 2013. We initiated the search with keywords related to "big data" and EHR. We identified relevant articles and additional keywords from the retrieved articles were added. Based on the new keywords, more articles were retrieved and we manually narrowed down the set utilizing predefined inclusion and exclusion criteria.RESULTS: Our final review includes articles categorized into the themes of data mining (pharmacovigilance, phenotyping, natural language processing), data application and integration (clinical decision support, personal monitoring, social media), and privacy and security.CONCLUSION: The increasing adoption of EHR systems worldwide makes it possible to capture large amounts of clinical data. There is an increasing number of articles addressing the theme of "big data", and the concepts associated with these articles vary. The next step is to transform healthcare big data into actionable knowledge.