Data and Information in the Sea of Electronic Health Records.
Data and Information in the Sea of Electronic Health Records.
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电子健康记录海洋中的数据和信息。
DOI：
10.1161/circoutcomes.118.005247
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Matheny,MichaelE
中科院分区：
文献类型：
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作者：
Shah,RashmeeU;Matheny,MichaelE
尽管有丰富的电子医疗数据，但由于广泛的可用性和医疗保健确定覆盖范围，许多重要的临床调查仅限于行政索赔数据。具体来说，医疗保险数据包括数百万患者的人口统计数据、国际疾病分类代码、药物数据和较长时间内的成本数据。这样的数据是有利的，因为它们易于访问，使用标准变量定义，并且需要最少的数据清理。这些数据可以用于大规模的人口和趋势分析，但缺乏详细的临床细节，这对细致入微的分析来说是一个永恒的挑战。医疗保险数据通常缺乏临床决策、合并症和治疗的关键特征，导致错误分类和分析中无法测量的混淆。
Despite the abundance of electronic healthcare data, many important clini-cal investigations are limited to administrative claims data because of wide availability and healthcare ascertainment coverage. Specifically, Medicare data includes millions of patients with demographic data, International Classification of Diseases codes, medication data, and cost data over an extended period of time. Such data are advantageous because they are easily accessible, use standard variable definitions, and require minimal data cleaning. The data lend themselves to large population and trend analyses, but granular clinical details are absent, a perpetual challenge for nuanced analyses. Medicare data often lack key features of clinical decision making, comorbidities, and treatments that result in misclassification and unmeasured confounding in analyses.