Electronic primary dental care records in research: A case study of validation and quality assurance strategies

Abstract

KLW) Highlights 1. 1. Dental records used in research can provide insights into task division, skill mix and needsbased workforce planning 2. 2. A stringent protocol of data cleaning and validation is required before electronic dental records are used 3. 3. Validated electronic dental records can be used to undertake research around patient risk factors 4. 4. Researchers need to work with clinicians and software developers to obtain rich and reliable data for dental research Abstract Background: In dentistry, the use of electronic patient records for research is underexplored.The aim of this paper is to describe a case study process of obtaining research data (sociodemographic, clinical and workforce) from electronic primary care dental records, and outlining data cleaning and validation strategies. This study was undertaken at the University of Portsmouth Dental Academy (UPDA), which is a centre of education, training and provision of state funded services (National Health Services). UPDA's electronic patient management system is R4/Clinical +. This is a widely used system in general dental practices in the UK. Method:A two-phase process, involving first Pilot and second Main data extraction were undertaken. Using System Query Language (SQL), data extracts containing variables related to patients' demography, socio-economic status and dental care received were generated. A data cleaning and validation exercise followed, using a combination of techniques including Maletic and Marcus's (2000) general framework for data cleaning and Rahm and Haido's (2010) principles of data cleaning. Results: The findings of the case study support the use of a two-phase data extraction process. The data validation processes highlighted the need for both manual and analytical strategies when cleaning these data. Finally, the process demonstrated that electronic dental records can be validated and used for epidemiological and heath service research. The potential to generalise findings is great due to the large number of records. There are, however, limitations to the data which need to be considered, relating to quality (data input), database structure and interpretation of data codes. Conclusion:Electronic dental records are useful in health service research, epidemiological studies and skill mix research. Researchers should work closely with, clinicians, managers and software developers to ensure that the data generated are accurate, valid and generalizable. Following data extraction, the research need to adapt stringent validation and data cleaning strategies to guarantee that the extracted electronic data are accurate.

Deprivation, demography and missed scheduled appointments at an NHS primary dental care and training service

“…At present the extraction of electronic dental records has not advanced to efficiently include presenting complaints. This is because there is a lack of diagnostic codes in dentistry [16]. In addition, free text language queries are yet to be developed to reliably extract data.…”

“…The data had been anonymised by the dental school's Data Custodians. The data were cleaned and validated using the methodology set out by Wanyonyi, Radford and Gallagher (2019) [16]. During this process, data inputting errors were identified and then cleaned after a validation process was undertaken to identify inconsistencies and outliers in the data.…”

Neighbourhood school environment and dental care needs amongst 5-to-11-year-old children attending a local dental facility in South-East England

“…This research has four important strengths. First, the study involves the use of validated and published data on patient management (Wanyonyi et al 2017(Wanyonyi et al , 2019, which helps to avoid patient recall and selection biases (Hennekens et al 1987). Similarly, Ofsted inspects all state-funded primary schools of various types (Office for Standards in Education 2020).…”

“…The first dataset was acquired from an open-access publication (Wanyonyi et al 2017) and comprised the electronic dental records (2008)(2009)(2010)(2011)(2012) of children attending the University of Portsmouth Dental Academy (UPDA), an NHS primary dental care service and training centre, located within Portsmouth LA in South-East England. Details of the data collection, cleaning and validation can be found in previous publications (Wanyonyi et al 2017(Wanyonyi et al , 2019. The data included completed or closed courses of both emergency and planned care provided over four years (Wanyonyi et al 2017).…”

Electronic Health Records in Dental Education: A Scoping Review and Quantitative Analysis of Publications

“…Rapid advances in those technologies and applications increase new opportunities into existing health care services [2]. The initial reason for this necessity was to upgrade administrative functions of healthcare organizations due to its sizeable amount of data through health records generated [3]. Potential applications of this type of technology are health promotion and community mobilization actions; health education campaigns; epidemiological surveillance and monitoring; development of decision-making support systems [1].…”