Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Medicine, The Ohio State University, Columbus, Ohio, USA.
J Am Med Inform Assoc. 2021 Mar 18;28(4):695-703. doi: 10.1093/jamia/ocaa315.
Family health history is important to clinical care and precision medicine. Prior studies show gaps in data collected from patient surveys and electronic health records (EHRs). The All of Us Research Program collects family history from participants via surveys and EHRs. This Demonstration Project aims to evaluate availability of family health history information within the publicly available data from All of Us and to characterize the data from both sources.
Surveys were completed by participants on an electronic portal. EHR data was mapped to the Observational Medical Outcomes Partnership data model. We used descriptive statistics to perform exploratory analysis of the data, including evaluating a list of medically actionable genetic disorders. We performed a subanalysis on participants who had both survey and EHR data.
There were 54 872 participants with family history data. Of those, 26% had EHR data only, 63% had survey only, and 10.5% had data from both sources. There were 35 217 participants with reported family history of a medically actionable genetic disorder (9% from EHR only, 89% from surveys, and 2% from both). In the subanalysis, we found inconsistencies between the surveys and EHRs. More details came from surveys. When both mentioned a similar disease, the source of truth was unclear.
Compiling data from both surveys and EHR can provide a more comprehensive source for family health history, but informatics challenges and opportunities exist. Access to more complete understanding of a person's family health history may provide opportunities for precision medicine.
家族病史对于临床护理和精准医疗非常重要。先前的研究表明,患者调查和电子健康记录 (EHR) 中收集的数据存在差距。“所有人研究计划”通过调查和 EHR 从参与者那里收集家族病史。本示范项目旨在评估“所有人研究计划”中公开数据中家族健康史信息的可用性,并描述这两个来源的数据特征。
参与者通过电子门户完成调查。EHR 数据被映射到观察性医疗结果伙伴关系数据模型。我们使用描述性统计对数据进行探索性分析,包括评估一系列具有医学可操作性的遗传疾病清单。我们对同时具有调查和 EHR 数据的参与者进行了子分析。
有 54872 名参与者具有家族病史数据。其中,26%只有 EHR 数据,63%只有调查数据,10.5%两者都有。有 35217 名参与者报告了具有医学可操作性的遗传疾病家族史(9%来自 EHR,89%来自调查,2%来自两者)。在子分析中,我们发现调查和 EHR 之间存在不一致。调查提供了更多细节。当两者都提到类似的疾病时,来源并不明确。
从调查和 EHR 中整合数据可以为家族病史提供更全面的来源,但也存在信息学挑战和机遇。更多地了解一个人的家族健康史可能为精准医疗提供机会。