From screening to ascertainment of the primary outcome using electronic health records: Challenges in the STRIDE trial

Electronic health record data are a rich resource and can be utilized to answer a wealth of research questions. It is important when using electronic health record data in clinical trials that systems be put in place and vetted prior to enrollment to ensure data elements can be collected consistently across all health care systems. It is often overlooked how something conceptualized on paper (e.g. use of the electronic health record in a study) can be difficult to implement in practice. This article discusses some of the challenges in using electronic health records in the conduct of the STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) trial, how we handled those challenges, and the lessons we learned for the conduct of future trials looking to employ the electronic health record.