Richesson R L, Horvath M M, Rusincovitch S A
Rachel Richesson, PhD, MPH, Duke University School of Nursing, 2007 Pearson Bldg, 311 Trent Drive, Durham, NC, 27710, USA, Tel: +1 (919) 681-0825, E-mai:
Yearb Med Inform. 2014 Aug 15;9(1):215-23. doi: 10.15265/IY-2014-0009.
The goal of this survey is to discuss the impact of the growing availability of electronic health record (EHR) data on the evolving field of Clinical Research Informatics (CRI), which is the union of biomedical research and informatics.
Major challenges for the use of EHR-derived data for research include the lack of standard methods for ensuring that data quality, completeness, and provenance are sufficient to assess the appropriateness of its use for research. Areas that need continued emphasis include methods for integrating data from heterogeneous sources, guidelines (including explicit phenotype definitions) for using these data in both pragmatic clinical trials and observational investigations, strong data governance to better understand and control quality of enterprise data, and promotion of national standards for representing and using clinical data.
The use of EHR data has become a priority in CRI. Awareness of underlying clinical data collection processes will be essential in order to leverage these data for clinical research and patient care, and will require multi-disciplinary teams representing clinical research, informatics, and healthcare operations. Considerations for the use of EHR data provide a starting point for practical applications and a CRI research agenda, which will be facilitated by CRI's key role in the infrastructure of a learning healthcare system.
本次调查的目的是探讨电子健康记录（EHR）数据可用性不断提高对临床研究信息学（CRI）这一不断发展的领域的影响，临床研究信息学是生物医学研究与信息学的结合。
将源自EHR的数据用于研究面临的主要挑战包括缺乏标准方法来确保数据质量、完整性和来源足以评估其用于研究的适用性。需要持续重点关注的领域包括整合来自异构源数据的方法、在务实的临床试验和观察性研究中使用这些数据的指南（包括明确的表型定义）、强大的数据治理以更好地理解和控制企业数据质量，以及推广临床数据表示和使用的国家标准。
EHR数据的使用已成为CRI的优先事项。了解基础临床数据收集过程对于将这些数据用于临床研究和患者护理至关重要，并且需要代表临床研究、信息学和医疗保健运营的多学科团队。使用EHR数据的考量为实际应用和CRI研究议程提供了一个起点，CRI在学习型医疗系统基础设施中的关键作用将推动这一议程。
