Presented at the Society for Academic Emergency Medicine annual meeting, June 2010, Phoenix, AZ.
Research Methods & Statistics
Electronic Versus Manual Data Processing: Evaluating the Use of Electronic Health Records in Out-of-hospital Clinical Research
Version of Record online: 9 FEB 2012
© 2012 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 19, Issue 2, pages 217–227, February 2012
How to Cite
Newgard, C. D., Zive, D., Jui, J., Weathers, C. and Daya, M. (2012), Electronic Versus Manual Data Processing: Evaluating the Use of Electronic Health Records in Out-of-hospital Clinical Research. Academic Emergency Medicine, 19: 217–227. doi: 10.1111/j.1553-2712.2011.01275.x
This project was supported by grants from the Robert Wood Johnson Foundation Physician Faculty Scholars Program; the National Heart, Lung, and Blood Institute (#5-U01-HL077873-01); the American Heart Association; and the Oregon Clinical and Translational Research Institute (grant # UL1 RR024140). These analyses were carried out by the investigators; neither the Clinical Trials Center nor the Publications Committee of the Resuscitation Outcomes Consortium takes responsibility for the analyses and interpretation of results.
The authors have no potential conflicts of interest to disclose.
Supervising Editor: James Holmes Jr., MD.
- Issue online: 9 FEB 2012
- Version of Record online: 9 FEB 2012
- Received May 9, 2011; revisions received July 25 and August 2, 2011; accepted August 9, 2011.
ACADEMIC EMERGENCY MEDICINE 2012; 19:217–227 © 2012 by the Society for Academic Emergency Medicine
Objectives: The objective was to compare case ascertainment, agreement, validity, and missing values for clinical research data obtained, processed, and linked electronically from electronic health records (EHR) compared to “manual” data processing and record abstraction in a cohort of out-of-hospital trauma patients.
Methods: This was a secondary analysis of two sets of data collected for a prospective, population-based, out-of-hospital trauma cohort evaluated by 10 emergency medical services (EMS) agencies transporting to 16 hospitals, from January 1, 2006, through October 2, 2007. Eighteen clinical, operational, procedural, and outcome variables were collected and processed separately and independently using two parallel data processing strategies by personnel blinded to patients in the other group. The electronic approach included EHR data exports from EMS agencies, reformatting, and probabilistic linkage to outcomes from local trauma registries and state discharge databases. The manual data processing approach included chart matching, data abstraction, and data entry by a trained abstractor. Descriptive statistics, measures of agreement, and validity were used to compare the two approaches to data processing.
Results: During the 21-month period, 418 patients underwent both data processing methods and formed the primary cohort. Agreement was good to excellent (kappa = 0.76 to 0.97; intraclass correlation coefficient [ICC] = 0.49 to 0.97), with exact agreement in 67% to 99% of cases and a median difference of zero for all continuous and ordinal variables. The proportions of missing out-of-hospital values were similar between the two approaches, although electronic processing generated more missing outcomes (87 of 418, 21%, 95% confidence interval [CI] = 17% to 25%) than the manual approach (11 of 418, 3%, 95% CI = 1% to 5%). Case ascertainment of eligible injured patients was greater using electronic methods (n = 3,008) compared to manual methods (n = 629).
Conclusions: In this sample of out-of-hospital trauma patients, an all-electronic data processing strategy identified more patients and generated values with good agreement and validity compared to traditional data collection and processing methods.