An in-silico method for epidemiological studies using Electronic Medical Records

观察性流行病学研究是识别 影响人口健康和疾病的因素，以及确定最佳 疾病的治疗，如癌症。然而，传统的流行病学 研究通常涉及人员密集的工作(如手工绘制图表和公开 记录审查)，并且在获得决定性结果之前可能非常耗时。 近期，已积累了大量详细的纵向临床数据 医院的电子病历(EMR)系统及其成为有价值的数据 流行病学研究的来源。然而，有两个障碍阻碍了 在流行病学研究中广泛使用电子病历数据。首先，大部分详细的临床 EMR中的信息嵌入到叙述性文本中，提取这些信息的成本非常高 手动提供信息。其次，EMR通常存在数据质量问题，例如 选择偏差和丢失数据，这需要对传统统计进行调整 为随机对照试验开发的方法。 在这项研究中，我们提出了一种基于电子信息学的方法 使用电子病历数据的观察性流行病学研究。我们假设现有的 电子病历数据可以非常有效地用于某些类型的流行病学研究 方式与信息学方法的帮助下。基于信息学的方法将 包含两个主要组件。一个是基于NLP(自然语言处理)的 一种可自动抽取详细临床信息的信息抽取系统 从电子病历和另一种是一套统计和信息学方法，可以用于 分析电子病历派生的数据。如果这种方法的可行性得到证明，它将改变 观察性流行病学研究的标准范式，因为它具有 能够在非常短的时间内以非常低的成本回答流行病学问题。 这项研究的具体目标是开发一种自动化信息学方法来 从急诊室和急诊室提取细粒度的癌症发现和一般临床信息 使用它们进行与癌症相关的流行病学研究。我们将执行这两个案例- 与预防和治疗乳房和结肠癌相关的对照和队列研究 使用电子病历数据的癌症。信息学方法将在两辆EMR上进行验证 各大医院展示其普适性。我们的流行病学调查结果 研究将与报道的结果进行比较，以进行验证。

Observational epidemiological studies are effective methods for identifying factors affecting the health and illness of populations, as well as for determining optimal treatments for diseases, such as cancers. However, conventional epidemiological research usually involves personnel-intensive effort (such as manual chart and public records review) and can be very time consuming before conclusive results are obtained. Recently, a large amount of detailed longitudinal clinical data has been accumulated at hospitals' Electronic Medical Records (EMR) systems and it has become a valuable data source for epidemiological studies. However, there are two obstacles that prevent the wide usage of EMR data in epidemiological studies. First, most of the detailed clinical information in EMRs is embedded in narrative text and it is very costly to extract that information manually. Second, EMRs usually have data quality problems such as selection bias and missing data, which require adaptation of conventional statistical methods developed for randomized controlled trials. In this study, we propose an in silico informatics-based approach for observational epidemiological studies using EMR data. We hypothesize that existing EMR data can be used for certain types of epidemiological studies in a very efficient manner with the help of informatics methods. The informatics-based approach will contain two major components. One is an NLP (Natural Language Processing) based information extraction system that can automatically extract detailed clinical information from EMR and another is a set of statistical and informatics methods that can be used to analyze EMR-derived data. If the feasibility of this approach is proven, it will change the standard paradigm of observational epidemiological research, because it has the capability to answer an epidemiological question in a very short time at a very low cost. The specific aim of this study is to develop an automated informatics approach to extract both fine-grained cancer findings and general clinical information from EMRs and use them to conduct cancer related epidemiological studies. We will perform both case- control and cohort studies related to prevention and treatment of breast and colon cancers using EMR data. The informatics approach will be validated on EMRs from two major hospitals to demonstrate its generalizability. Epidemiological findings from our study will be compared to reported findings for validation.