电子健康记录中的偏见 数据用于生成现实世界的证据:概述
Ban Al-Sahab1, Alan Leviton2,3, Tobias Loddenkemper2,3
1Department of Family Medicine, College of Human Medicine, Michigan State University, B100 Clinical Center, 788 Service Road, East Lansing, MI USA.
Journal of healthcare informatics research
|January 26, 2024
概括
电子健康记录 (EHR) 为研究提供了大量现实世界的数据,但包含了显著的偏见. 建议对从二次EHR数据分析得出的因果推断非常谨慎.
科学领域:
- 医疗信息学 医疗信息学
- 临床研究方法论 临床研究方法论
- 现实世界的证据生成
背景情况:
- 电子健康记录 (EHR) 越来越被认为是临床研究的宝贵数据来源.
- 电子健康记录提供了大量来自现实世界的临床环境的实时数据.
- 电子健康记录数据的二次使用为研究带来了机遇和挑战.
研究的目的:
- 审查EHR数据在临床研究中的二次用途.
- 确定机会和数据缺陷,限制因果推理.
- 提供一个全面的 EHR 数据生成和研究过程中偏见的概述.
主要方法:
- 关于电子健康记录数据的二次用途的文献综述.
- 在医疗保健系统和研究层面识别和分类偏见.
- 分析影响因果关系的数据缺陷和潜在偏差.
主要成果:
- 电子健康数据提供了巨大的潜力,但受到许多缺陷和偏见的影响.
- 偏见在医疗保健系统层面 (获得护理,数据文档) 和研究层面 (数据提取,分析,解释) 产生.
- 选择和信息偏见是限制因果推理有效性的突出问题.
结论:
- 由于固有的偏见,对EHR数据的次要使用需要极度谨慎.
- 仔细考虑数据缺陷和偏见来源对于有效的研究至关重要.
- 在没有严格的偏差缓解策略的情况下,从EHR数据中推断因果关系的可能性是有限的.
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