ArticleEGEMS (Washington, DC)2015
Linking electronic health records to better understand breast cancer patient pathways within and between two health systems.
Article in EGEMS (Washington, DC), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Evaluating Privacy-Preserving Record Linkage in Merging Cancer Registry Data and Electronic Health Records.Journal of registry management · 2025Article
- Impact of observability period on the classification of COPD diagnosis timing among Medicare beneficiaries with lung cancer.PLOS digital health · 2024Article
- COPD With Lung Cancer Among Older United States Adults: Prevalence, Diagnostic Timeliness, and Association With Earlier Stage Tumors.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2024Article
- Early Ascertainment of Breast Cancer Diagnoses Comparing Self-Reported Questionnaires and Electronic Health Record Data Warehouse: The WISDOM Study.JCO clinical cancer informatics · 2023Article
- Semi-supervised calibration of noisy event risk (SCANER) with electronic health records.Journal of biomedical informatics · 2023Article
- Role of digital health in coordinating patient care in a hub-and-spoke hierarchy of cancer care facilities: a scoping review.Ecancermedicalscience · 2023Article
- Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females.Journal of the National Cancer Institute · 2022Article
- Leveraging Electronic Health Records to Address Breast Cancer Disparities.Current breast cancer reports · 2022Review
- Integrating Electronic Health Record, Cancer Registry, and Geospatial Data to Study Lung Cancer in Asian American, Native Hawaiian, and Pacific Islander Ethnic Groups.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Characterization of bariatric surgery and outcomes using administrative claims data in the research network of a nationwide commercial health plan.BMC health services research · 2021Observational
- Validation of Real-World Data-based Endpoint Measures of Cancer Treatment Outcomes.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2021Article
- Population-Based Registry Linkages to Improve Validity of Electronic Health Record-Based Cancer Research.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- Leveraging Digital Data to Inform and Improve Quality Cancer Care.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Article
- Using natural language processing to construct a metastatic breast cancer cohort from linked cancer registry and electronic medical records data.JAMIA open · 2019Article
- System-based approaches as prognostic tools for glioblastoma.BMC cancer · 2019Review
- A conceptual framework for evaluating data suitability for observational studies.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Illustrating Informed Presence Bias in Electronic Health Records Data: How Patient Interactions with a Health System Can Impact Inference.EGEMS (Washington, DC) · 2017Article
- Patient healthcare trajectory. An essential monitoring tool: a systematic review.Health information science and systems · 2017Review
- Assessing Community Cancer care after insurance ExpanSionS (ACCESS) study protocol.Contemporary clinical trials communications · 2017Article
- Synergistic drug combinations from electronic health records and gene expression.Journal of the American Medical Informatics Association : JAMIA · 2017Article
Corrections and comments
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3 authors.
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Abstract
introductionIn a fragmented health care system, research can be challenging when one seeks to follow cancer patients as they seek care which can continue for months or years and may reflect many physician and patient decisions. Claims data track patients, but lack clinical detail. Linking routine electronic health record (EHR) data with clinical registry data allows one to gain a more complete picture of the patient journey through a cancer care episode. However, valid analytical approaches to examining care trajectories must be longitudinal and account for the dynamic nature of what is "seen" in the EHR.
methodsThe Oncoshare database combines clinical detail from the California Cancer Registry and EHR data from two large health care organizations in the same catchment area-a multisite community practice and an academic medical center-for all women treated in either organization for breast cancer from 2000 to 2012. We classified EHR encounters data according to typical periods of the cancer care episode (screening, diagnosis, treatment) and posttreatment surveillance, as well as by facility used to better characterize patterns of care for patients seen at both organizations.
findingsWe identified a "treated" cohort consisting of women receiving interventions for their initial cancer diagnosis, and classified their encounters over time across multiple dimensions (type of care, provider of care, and timing of care with respect to their cancer diagnosis). Forty-three percent of the patients were treated at the academic center only, 42 percent at the community center only, and 16 percent of the patients obtained care at both health care organizations. Compared to women seen at only one organization, the last group had similar-length initial care episodes, but more frequently had multiple episodes and longer observation periods. DISCUSSION: Linking EHR data from neighboring systems can enhance our information on care trajectories, but careful consideration of the complexity of the treatment process and data generating mechanisms is necessary to make valid inferences. CONCLUSION/NEXT STEPS: If analyzed as a timeline, and with careful characterization of diagnostic tests, surgical interventions, and type and frequency of physician encounters, the pathways taken by women through their breast cancer episode may lead to better understanding of patient decisions.
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