Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Nov 24, 2019
Date Accepted: Apr 21, 2020
Evaluating the Representativeness of US Centricity Electronic Medical Records with Reports from Centers for Disease Control and Prevention: Office Visits and Cardiometabolic Conditions.
ABSTRACT
Background:
Electronic Medical Record (EMR) based clinical and epidemiological research has dramatically increased over the last decade, although establishing the generalizability of such big databases for conducting epidemiological studies has been an ongoing challenge. To draw meaningful inferences from such studies, it is essential to fully understand the characteristics of underlying population and potential biases in EMRs.
Objective:
To assess generalizability and representativity of the US Centricity EMR (CEMR) research database with US survey data.
Methods:
The number of office visits and the distribution of major cardiometabolic diseases reported in The National Ambulatory Medical Care Survey (NAMCS) and the National Health and Nutrition Examination Surveys (NHANES) were compared with similar data from CEMR.
Results:
Number of office visits per 100 persons per year (95% CI) was similar: 278 (259, 297) in NAMCS and 285 (284, 285) in CEMR. However, the number of visits for male was significantly higher in CEMR (CEMR / NAMCS: 271 / 239). West regions were underrepresented and South overrepresented in CEMR. The overall prevalence of diabetes along with age and gender distribution was similar in CEMR and NHANES: overall prevalence – 10% and 10%, male – 12% and 11%, female – 9% and 9%, age 20-40 years – 3% and 2%, age 40-60 years – 9% and 11%. The prevalence of obesity was similar: 42% and 40%, with similar age and female distribution (42% and 41%), but different in male distribution (43% and 38%). The overall prevalence of high cholesterol along with age and female distribution was similar in CEMR and NHANES: overall prevalence – 12% and 12%, female – 15% and 13%. The overall prevalence of hypertension was significantly higher in CEMR (34%) compared with NHANES survey (95% CI: 27 – 31%).
Conclusions:
The distribution of major cardiometabolic diseases in CEMR is representative of the national survey results. CEMR represents general US population well in terms of office visits and major chronic conditions, while the potential subgroup differences in terms of age and sex distribution and prevalence may differ and therefore should be carefully taken care of in the future studies. Clinical Trial: NA
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