Improving the Quality and Design of Retrospective Clinical Outcome Studies that Utilize Electronic Health Records

Abstract

Description Electronic health records (EHRs) are an excellent source for secondary data analysis. Studies based on EHR-derived data, if designed properly, can answer previously unanswerable clinical research questions. In this paper we will highlight the benefits of large retrospective studies from secondary sources such as EHRs, examine retrospective cohort and case-control study design challenges, as well as methodological and statistical adjustment that can be made to overcome some of the inherent design limitations, in order to increase the generalizability, validity and reliability of the results obtained from these studies.

Methodological Quality of Retrospective Observational Studies Investigating Effects of Diabetes Monitoring Systems: a Systematic Review

“…28 Our ndings demonstrate the barriers of applying retrospective observational studies to clinical, regulatory, or HTA decision-making. [30][31][32] However, given the bene ts of ROSs, especially when conducting a prospective study was not feasible or too expensive, 3,21 collaborative efforts may be needed to properly apply these studies with suboptimal quality. In addition, to following general recommendations proposed by previous research, such as lling evidence gap when RCTs are not available, 32,33 we recommend decision-makers to improve the alignment of decision-making criteria, and to put more weight on major contributors to low quality.…”

“…20 To improve quality of ROSs and to establish credibility of their ndings, many efforts have been taken in the past ten years, such as developing and applying advanced methods for bias adjustment and developing tools for researchers. 21,22 However, we don't know whether the existing efforts have contributed to the improved quality, in terms of risk of bias (RoB). Hence, our study aims to systematically identify retrospective observational studies investigating effects of diabetes monitoring systems, to evaluate their RoB, and to explore the trend in quality over time.…”

Could we prove the nursing outcomes utilising clinical data warehouse? Effectiveness of pressure ulcer intervention in Korean tertiary hospital

“…The use of de‐identified EMR patient health information for research and quality improvement has become more frequent in the last 10 years. 24 A recent retrospective analysis used de‐identified wound expert EMR from 242 wound care facilities across the United States over a 5‐year period. The results found significant differences in frequency and the time of healing when using human fibroblast‐derived dermal substitute in patients with diabetic foot ulcers, and the findings could imply overall cost savings for medical resources, home health, prescription drugs, physician office visits, emergency department visits and hospitalizations.…”

Retrospective analysis of electronic health records of patients with heart failure: the first Russian experience

“…Следует отметить, что в целом записи в ЭМК первоначально были разработаны для более эффективного и полного учета оплаты медицинских расходов [3]. Другие функции записей в ЭМК по значимости обычно распределяют таким образом: получение информации о состоянии здоровья пациентов, оценка результатов лечения, формирования заказов и управление ими, поддержка принятия решения, обеспечение связей и обмена данными, поддержка пациентов, администрирование и сообщение о достигнутых результатах, а также управление здравоохранением [4].…”