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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 20, 2025
Date Accepted: Feb 5, 2026

The final, peer-reviewed published version of this preprint can be found here:

AI in Clinical Decision Support Systems: Promising Applications and Strategies for Managing Data Challenges

Daly JE, Honerlaw J, Cho K, Smith R, Li C, Eberhart A, Bennett B, Wickremasinghe IM, Sippel J

AI in Clinical Decision Support Systems: Promising Applications and Strategies for Managing Data Challenges

J Med Internet Res 2026;28:e71532

DOI: 10.2196/71532

PMID: 42081797

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Viewpoint on Big Data Analytics for Improved Patient Outcomes: Applications of the Veterans Health Administration Spinal Cord Injuries and Disorders Registry (VHA SCIDR) for Precision Medicine

  • Jennifer E. Daly; 
  • Jacqueline Honerlaw; 
  • Kelly Cho; 
  • River Smith; 
  • Chao Li; 
  • Adam Eberhart; 
  • Bridget Bennett; 
  • I. Manosha Wickremasinghe; 
  • Jennifer Sippel

ABSTRACT

Background:

Since the 1990s, the Veterans Health Administration (VHA) has maintained a system-wide digital database to provide integrated care for 9 million Veterans across 172 medical centers and 1,138 outpatient clinics in the United States.

Objective:

This paper highlights applications of VHA Big Data and the VHA Spinal Cord Injuries and Disorders Registry (VHA SCIDR) to precisely meet Veterans’ changing medical needs.

Methods:

The modernized VHA SCIDR uses a case-finding algorithm to extract data from Veterans’ electronic medical record (EMR). This data along with longitudinal data from other VHA sources yield robust models of population health to inform the development of cost-effective and targeted services for people living with Spinal Cord Injuries and Disorders (SCI/D).

Results:

Data from four VHA SCIDR data collection methods were consolidated to create a dataset of 73,947 living and deceased Veterans who received care from 1994 through 2022. As of January 2025, the modernized VHA SCIDR operational database includes 23,262 living Veterans who receive VHA SCI/D System of Care services.

Conclusions:

Applications of VHA Big Data illustrate how biomedical informatics can improve the precision of care for people living with SCI/D. Synthetic datasets are one strategy VHA is using to develop and test data models and allow comparisons with non-Veteran data. VHA Big Data supports precision medicine with informatics, machine learning, and artificial intelligence tools that leverage a vast array of data to improve outcomes through the delivery of precise, seamless medical care. Clinical Trial: None


 Citation

Please cite as:

Daly JE, Honerlaw J, Cho K, Smith R, Li C, Eberhart A, Bennett B, Wickremasinghe IM, Sippel J

AI in Clinical Decision Support Systems: Promising Applications and Strategies for Managing Data Challenges

J Med Internet Res 2026;28:e71532

DOI: 10.2196/71532

PMID: 42081797

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