Estimating screening test utilization using electronic health records data

EGEMS
Ra HubbardCm Rutter

Abstract

Electronic health records (EHRs) are increasingly used by medical providers and offer a wide-reaching source of information on utilization of preventive services. Numerous measures used for quality assessment and public reporting are estimated based on EHR data. However, sources of error and misclassification can lead to over- or under-estimation of true utilization rates. EHR-derived measures of screening test use are subject to error due to misclassification of screening and diagnostic tests. The implications of this misclassification for EHR-based screening utilization estimates have not been well explored. We calculated the bias in estimates of screening test utilization associated with several published EHR-based algorithms for identifying screening colonoscopies and propose two simple methods to correct this bias. We apply these corrections to obtain adjusted estimates of screening colonoscopy utilization using EHR data from Group Health, an integrated healthcare system in Washington-state. The bias in screening colonoscopy utilization estimates ranged from an under-estimate of 3 to an over-estimate of 12 percentage points across classification methods. If the operating characteristics of the classification method are kno...Continue Reading

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LASSO

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