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使用链接电子健康记录评估索赔数据中的未测量混因素:一项原则证明分析

Sushama Kattinakere Sreedhara¹, Haritha S Pillai¹, Rishi J Desai¹

¹Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Clinical pharmacology and therapeutics

|February 18, 2026

概括

电子健康记录 (EHR) 可以通过捕捉保险索赔数据中遗漏的因素来改善药物安全研究. 链接索赔和EHR数据有助于减轻混,增强现实世界的证据分析.

科学领域:

现实世界的证据研究研究.
药学流行病学药学流行病学
医疗信息学医疗信息学

背景情况:

索赔数据分析容易产生剩余和未测量的混.
声明中没有很好地捕捉到的因素,比如实验室结果或医生笔记,通常可以在电子健康记录 (EHR) 中获得.
强大的链接到EHR索赔数据基础设施对于先进的药物安全监测至关重要.

研究的目的:

展示一个评估混因素的过程,这些因素在索赔中表现得很差,但在EHR中可以衡量.
评估EHR数据的潜力,以减轻药物安全监督中的混.
通过链接索赔-EHR数据评估血管风险因素的平衡.

主要方法:

利用了来自美国食品和药物管理局哨兵计划的Mass General Brigham网站的链接索赔-EHR数据.
提取了以前在基于索赔的查询中使用的队列,将sacubitril-valsartan启动剂与ACE抑制剂或ARBs进行比较.
使用EHR数据特征化血管风险因素,并将其与基于索赔的代理进行比较.

主要成果:

基于索赔的代理有效地平衡了大多数只能在电子健康记录数据中测量的风险因素.
该研究作为使用EHR数据解决混问题的原则证明.
由于关键风险因素的平衡,定量偏差分析被认为是不必要的.

结论:

链接的EHR-claims数据可以通过解决混问题来加强药物安全监督.
这种方法可以与其他敏感性分析一起用于剩余混评估.
一个强大的链接数据基础设施对于药物监测的常规应用至关重要.

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