Methods for the analysis and assessment of clinical databases: the clinician's perspective

Innovative approaches to analysing clinical databases can be considered from a perspective of innovations that improve the analytical approach or from a more global perspective in which clinical databases themselves are evaluated as a technology. The analytic approach for using a database to estimate risk can be considered as a matrix of three methodologic concerns: the predictive method; the assessment of the quality of the predictions; and the assessment of the validity or generalizability of the predictions. Considering databases as a technology places in perspective the merit of clinical databases and defines their potential value to the health care system. An awareness of both the clinical and analytic problem encourages innovation and can lead to creative solutions to the many problems present in the analysis of clinical databases.