Evidence map›Paper›PMID 32252642›Full record

ArticleBMC medical research methodology2020

Prevalence estimation by joint use of big data and health survey: a demonstration study using electronic health records in New York city.

Ryung S Kim, Viswanathan Shankar

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Article in BMC medical research methodology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

2 authors.

Ryung S KimDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. ryung.kim@einsteinmed.org.
Viswanathan ShankarDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.

Funding

New York City Department of Health and Mental Hygiene (US) The study began as the authors worked as paid statistical consultants for NYC DOHMH to analyze NYC Macroscope jointly with NYC HANES. When the work ended, the authors continued further simulation studies to write the manuscript.New York City Department of Health and Mental Hygine The study began as the authors worked as paid statistical consultants for NYC DOHMH to analyze NYC Macroscope jointly with NYC HANES. When the work ended, the authors continued further simulation studies to write the manuscript.
6 · The paper itself

Abstract

backgroundElectronic Health Records (EHR) has been increasingly used as a tool to monitor population health. However, subject-level errors in the records can yield biased estimates of health indicators. There is an urgent need for methods to estimate the prevalence of health indicators using large and real-time EHR while correcting the potential bias.

methodsWe demonstrate joint analyses of EHR and a smaller gold-standard health survey. We first adopted Mosteller's method that pools two estimators, among which one is potentially biased. It only requires knowing the prevalence estimates from two data sources and their standard errors. Then, we adopted the method of Schenker et al., which uses multiple imputations of subject-level health outcomes that are missing for the subjects in EHR. This procedure requires information to link some subjects between two sources and modeling the mechanism of misclassification in EHR as well as modeling inclusion probabilities to both sources.

resultsIn a simulation study, both estimators yielded negligible bias even when EHR was biased. They performed as well as health survey estimator when EHR bias was large and better than health survey estimator when EHR bias was moderate. It may be challenging to model the misclassification mechanism in real data for the subject-level imputation estimator. We illustrated the methods analyzing six health indicators from 2013 to 14 NYC HANES and the 2013 NYC Macroscope, and a study that linked some subjects in both data sources.

conclusionsWhen a small gold-standard health survey exists, it can serve as a safeguard against potential bias in EHR through the joint analysis of the two sources.

Indexed as

Big DataElectronic Health RecordsHumansNew York CityPopulation SurveillancePrevalenceBig dataElectronic health recordsMeasurement errorMultiple imputationsPopulation health surveillanceSelection bias

Identifiers

PMID32252642
PMCPMC7137316

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