Prospective EHR-Based Clinical Trials: The Challenge of Missing Data

The Value of Unstructured Electronic Health Record Data in Geriatric Syndrome Case Identification

“…The value of structured EHR data was in line with findings from other studies that assessed the value of EHR data in identifying high-risk individuals for healthcare utilization and improving population health management interventions. 29,30 Added Value of Unstructured EHR Data Extracting information on geriatric syndromes from unstructured EHR data identified a considerable number of individuals in the study population who were missed using structured data only (claims or EHR), 31 although the "iceberg phenomenon" of the unstructured EHR data (referring to the hidden cases within the EHR free-text) varied according to geriatric risk factor (e.g., highest value in malnutrition (94.6%) and social support syndromes (99.8%) gains; lowest for decubitus ulcer (50.7%) and dementia (38.7%) gains). This might be partly derived from the fact that some geriatric syndromes are well Figure 3.…”

Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record

“…Sometimes necessary or expected data elements might be missing in a patient’s record. Missing data rates in the EHR have been previously reported from 20% to 80% 16, 17 . In this study, we were interested in clinical data between postoperative day 3 to 30 (which we refer to as the postoperative window henceforth) because the first two days after surgery often constitute a recovery period, where abnormal measurements are common and may simply be a result of healing from the trauma caused by surgery, rather than a sign of SSI.…”

Novel Approach to Inpatient Fall Risk Prediction and Its Cross-Site Validation Using Time-Variant Data (Preprint)

“…One of the challenges in EMR-based studies is the presence of missing data. [12,33] We observed about 63% missing data for the riskassessment-tool score and 10% of the KPCS score and subscores. The missing riskassessment-tool score data was due to the hospital's local policy that specified reassessment period at everyday for all or at two or three times a week for at-risk patients and once a week for no-risk patients as well as changes in status.…”