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Search All Research Studies
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- Ambulatory Care and Surgery (1)
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- (-) Electronic Health Records (EHRs) (13)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedHuo T, Glueck DH, Shenkman EA
Stratified split sampling of electronic health records
Data extracted from electronic health records may require very different approaches for model building and analysis than data from clinical research. Because electronic health record data is designed for clinical use, researchers need to engage in the iterative process of defining and provide clear definitions of outcome and predictor variables and assessing associations. This process can increase Type I error rates and decrease the chance of replicability. Failure to consider subgroups may mask heterogeneous relationships between predictor and outcome by subgroups, thus decreasing the generalizability of the findings. To improve the likelihood of both replicability and generalizability, the researchers recommended utilizing a stratified split sample approach for studies using electronic health records. The researchers illustrate the approach through an electronic health record study of the relationships between socio-demographic factors and uptake of hepatic cancer screening, and potential heterogeneity of association in subgroups defined by gender, self-identified race and ethnicity, census-tract level poverty and insurance type.
AHRQ-funded; HS028283.
Citation: Huo T, Glueck DH, Shenkman EA .
Stratified split sampling of electronic health records
BMC Med Res Methodol 2023 May 25; 23(1):128. doi: 10.1186/s12874-023-01938-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Health Services Research (HSR)
Russell LB, Huang Q, Lin Y
The electronic health record as the primary data source in a pragmatic trial: a case study.
Electronic health records are a series of overlapping and legacy systems that require time and expertise to use efficiently. Commonly measured patient characteristics are relatively easy to locate for most trial enrollees but less common characteristics are not. Acquiring essential supplementary data - in this trial, state data on hospital admission - can be a lengthy and difficult process.
AHRQ-funded; HS026372.
Citation: Russell LB, Huang Q, Lin Y .
The electronic health record as the primary data source in a pragmatic trial: a case study.
Med Decis Making 2022 Nov;42(8):975-84. doi: 10.1177/0272989x211069980..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Young JC, Dasgupta N, Stürmer T
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
The authors linked electronic health record (EHR) data from a large academic health system to Medicare insurance claims for patients undergoing surgery. When characterizing opioid exposure, they found substantial discrepancies between EHR medication orders and prescription claims data. In all time periods assessed, most patients' use was reflected only in the EHR, or only in the claims, but not both.
AHRQ-funded; HS000032.
Citation: Young JC, Dasgupta N, Stürmer T .
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
Pharmacoepidemiol Drug Saf 2022 Aug;31(8):913-20. doi: 10.1002/pds.5452..
Keywords: Research Methodologies, Electronic Health Records (EHRs), Health Information Technology (HIT)
Rodriguez PJ, Ward ZJ, Long MW
Applied methods for estimating transition probabilities from electronic health record data.
This study examined the usefulness of electronic health records (EHRs) in estimating transition probabilities for state-transition models. No guidelines exist on appropriate methods. The authors used 3 potential methods to estimate transition probabilities for EHR data, using pediatric eating disorders (EDs) as a case study. They mapped diagnoses to 3 ED health states: anorexia nervous, bulimia nervosa, and other specified feeding or eating disorder using data from PEDsnet, which includes 8 US children’s hospitals. They used 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. The first-last proportion approach estimated higher probabilities of remaining the same health state, while the other two approaches estimated higher probabilities of transitioning to a different health state. Published literature differed substantially from these estimates. Further research is needed to improve methods for using EHR data to inform transition probabilities.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Ward ZJ, Long MW .
Applied methods for estimating transition probabilities from electronic health record data.
Med Decis Making 2021 Feb;41(2):143-52. doi: 10.1177/0272989x20985752..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Nuamah JK, Adapa K, Mazur L
Electronic health records (EHR) simulation-based training: a scoping review protocol.
This article describes a literature review that will be conducted on the evidence for electronic health record (EHR)-based training interventions to facilitate improved EHR use for healthcare providers. Three databases will be searched for published articles and ProQuest and Google Scholar will be searched to identify unpublished articles from inception to January 29, 2020. Two reviewers will independently screen titles and abstracts using inclusion and exclusion criteria. Based on the extracted data, research evidence will be synthesized.
AHRQ-funded; HS025597.
Citation: Nuamah JK, Adapa K, Mazur L .
Electronic health records (EHR) simulation-based training: a scoping review protocol.
BMJ Open 2020 Aug 11;10(8):e036884. doi: 10.1136/bmjopen-2020-036884..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Simulation
Di Tosto G, McAlearney AS, Fareed N
Metrics for outpatient portal use based on log file analysis: algorithm development.
This study’s goal was to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data and to provide insights into how patients use this tool. The authors developed a taxonomy of functions and actions and computed analytic metrics, including frequency and comprehensiveness of use. They found that function use was comprehensive at the patient level, while each session was instead limited to the use of one specific function. They hope to promote the replicability of their study at other institutions and to contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable the measurement of patient engagement based on the outpatient portal use.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Di Tosto G, McAlearney AS, Fareed N .
Metrics for outpatient portal use based on log file analysis: algorithm development.
J Med Internet Res 2020 Jun 12;22(6):e16849. doi: 10.2196/16849..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Health Services Research (HSR), Research Methodologies
Weng Y, Tian L, Tedesco D
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Postoperative pain scores are widely monitored and collected in the electronic health record, yet current methods fail to fully leverage the data with fast implementation. This article describes a trajectory analysis for postoperative pain using electronic health records. A robust linear regression was fitted to describe the association between the log-scaled pain score and time from discharge after total knee replacement.
AHRQ-funded; HS024096.
Citation: Weng Y, Tian L, Tedesco D .
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Health Informatics J 2020 Jun;26(2):1404-18. doi: 10.1177/1460458219881339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Pain, Surgery, Orthopedics, Research Methodologies, Health Services Research (HSR)
Vemulakonda VM, Bush RA, Kahn MG
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
This literature study examined the use of electronic health records (EHRs) to facilitate research in pediatric urology. The use of EHRs has been strongly encouraged by US federal agencies, including AHRQ. The researchers found that EHR use for research has strengths and weaknesses and more collaboration is needed to identify the method that best suits incorporation of research-oriented data collection into routine pediatric urologic clinical practice.
AHRQ-funded; HS024597; HS022404.
Citation: Vemulakonda VM, Bush RA, Kahn MG .
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
J Pediatr Urol 2018 Oct;14(5):374-81. doi: 10.1016/j.jpurol.2018.04.033..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Simon KC, Tideman S, Hillman L
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
The purpose of this study was to demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design. The authors suggest that the demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
AHRQ-funded; HS024057.
Citation: Simon KC, Tideman S, Hillman L .
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
JAMIA Open 2018 Jul;1(1):99-106. doi: 10.1093/jamiaopen/ooy017..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, System Design
Hoffman SR, Vines AI, Halladay JR
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
The objective of the study was to develop an electronic health record-based algorithm to identify women with symptomatic uterine fibroids for a comparative effectiveness study of medical or surgical treatments on quality-of-life measures. The study concluded that an electronic health record-based algorithm is capable of identifying cases of symptomatic uterine fibroids with moderate positive predictive value and may be an efficient approach for large-scale study recruitment.
AHRQ-funded; HS023418.
Citation: Hoffman SR, Vines AI, Halladay JR .
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
Am J Obstet Gynecol 2018 Jun;218(6):610.e1-10.e7. doi: 10.1016/j.ajog.2018.02.002..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Research Methodologies, Women
Kim KK, Sankar P, Wilson MD
Factors affecting willingness to share electronic health data among California consumers.
The objective of the study is to explore factors that affect consumers' willingness to share electronic health information for healthcare and research. It concluded that consumers' choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control.
AHRQ-funded; HS019913.
Citation: Kim KK, Sankar P, Wilson MD .
Factors affecting willingness to share electronic health data among California consumers.
BMC Med Ethics 2017 Apr 4;18(1):25. doi: 10.1186/s12910-017-0185-x.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Research Methodologies
Cato KD, Bockting W, Larson E
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
Using the Belmont Report's principles of respect for persons, beneficence, and justice as a framework, the authors examined the ethical issues posed by electronic phenotyping. Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, and ensuring that the potential benefits justify the risks of harm to patients.
AHRQ-funded; HS022961.
Citation: Cato KD, Bockting W, Larson E .
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
J Empir Res Hum Res Ethics 2016 Jul;11(3):214-9. doi: 10.1177/1556264616661611.
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Keywords: Clinician-Patient Communication, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries, Research Methodologies
Keenan GM, Wilkie DJ
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
This commentary introduces a virtual edition of IJNK, hosted on the Journal’s website. It includes six articles published in the last 20 years that provide a snapshot of efforts to integrate one or more of the standardized terminologies, NANDA-I, NOC, NIC (NNN), into electronic health records (EHRs).
AHRQ-funded; HS015054.
Citation: Keenan GM, Wilkie DJ .
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
Int J Nurs Knowl 2014 Jun;25(2):68-9. doi: 10.1111/2047-3095.12039..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies