Equity and bias in electronic health records data

Andrew D. Boyd; Rosa Gonzalez-Guarda; Katharine Lawrence; Crystal L. Patil; Miriam O. Ezenwa; Emily C. O'Brien; Hyung Paek; Jordan M. Braciszewski; Oluwaseun Adeyemi; Allison M. Cuthel; Juanita E. Darby; Christina K. Zigler; P. Michael Ho; Keturah R. Faurot; Karen Staman; Jonathan W. Leigh; Dana L. Dailey; Andrea Cheville; Guilherme Del Fiol; Mitchell R. Knisely; Keith Marsolo; Rachel L. Richesson; Judith M. Schlaeger

doi:10.1016/j.cct.2023.107238

Equity and bias in electronic health records data

Andrew D. Boyd, Rosa Gonzalez-Guarda, Katharine Lawrence, Crystal L. Patil, Miriam O. Ezenwa, Emily C. O'Brien, Hyung Paek, Jordan M. Braciszewski, Oluwaseun Adeyemi, Allison M. Cuthel, Juanita E. Darby, Christina K. Zigler, P. Michael Ho, Keturah R. Faurot, Karen Staman, Jonathan W. Leigh, Dana L. Dailey, Andrea Cheville, Guilherme Del Fiol, Mitchell R. KniselyKeith Marsolo, Rachel L. Richesson, Judith M. Schlaeger

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

Abstract

Embedded pragmatic clinical trials (ePCTs) are conducted during routine clinical care and have the potential to increase knowledge about the effectiveness of interventions under real world conditions. However, many pragmatic trials rely on data from the electronic health record (EHR) data, which are subject to bias from incomplete data, poor data quality, lack of representation from people who are medically underserved, and implicit bias in EHR design. This commentary examines how the use of EHR data might exacerbate bias and potentially increase health inequities. We offer recommendations for how to increase generalizability of ePCT results and begin to mitigate bias to promote health equity.

Original language	English (US)
Article number	107238
Journal	Contemporary Clinical Trials
Volume	130
DOIs	https://doi.org/10.1016/j.cct.2023.107238
State	Published - Jul 2023

Keywords

Community engagement
Health equity
Health literacy
Patient-reported outcomes
Social determinants of health

ASJC Scopus subject areas

Pharmacology (medical)

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10.1016/j.cct.2023.107238

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Boyd, A. D., Gonzalez-Guarda, R., Lawrence, K., Patil, C. L., Ezenwa, M. O., O'Brien, E. C., Paek, H., Braciszewski, J. M., Adeyemi, O., Cuthel, A. M., Darby, J. E., Zigler, C. K., Ho, P. M., Faurot, K. R., Staman, K., Leigh, J. W., Dailey, D. L., Cheville, A., Del Fiol, G., ... Schlaeger, J. M. (2023). Equity and bias in electronic health records data. Contemporary Clinical Trials, 130, Article 107238. https://doi.org/10.1016/j.cct.2023.107238

Boyd, AD, Gonzalez-Guarda, R, Lawrence, K, Patil, CL, Ezenwa, MO, O'Brien, EC, Paek, H, Braciszewski, JM, Adeyemi, O, Cuthel, AM, Darby, JE, Zigler, CK, Ho, PM, Faurot, KR, Staman, K, Leigh, JW, Dailey, DL, Cheville, A, Del Fiol, G, Knisely, MR, Marsolo, K, Richesson, RL & Schlaeger, JM 2023, 'Equity and bias in electronic health records data', Contemporary Clinical Trials, vol. 130, 107238. https://doi.org/10.1016/j.cct.2023.107238

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title = "Equity and bias in electronic health records data",

abstract = "Embedded pragmatic clinical trials (ePCTs) are conducted during routine clinical care and have the potential to increase knowledge about the effectiveness of interventions under real world conditions. However, many pragmatic trials rely on data from the electronic health record (EHR) data, which are subject to bias from incomplete data, poor data quality, lack of representation from people who are medically underserved, and implicit bias in EHR design. This commentary examines how the use of EHR data might exacerbate bias and potentially increase health inequities. We offer recommendations for how to increase generalizability of ePCT results and begin to mitigate bias to promote health equity.",

keywords = "Community engagement, Health equity, Health literacy, Patient-reported outcomes, Social determinants of health",

author = "Boyd, {Andrew D.} and Rosa Gonzalez-Guarda and Katharine Lawrence and Patil, {Crystal L.} and Ezenwa, {Miriam O.} and O'Brien, {Emily C.} and Hyung Paek and Braciszewski, {Jordan M.} and Oluwaseun Adeyemi and Cuthel, {Allison M.} and Darby, {Juanita E.} and Zigler, {Christina K.} and Ho, {P. Michael} and Faurot, {Keturah R.} and Karen Staman and Leigh, {Jonathan W.} and Dailey, {Dana L.} and Andrea Cheville and {Del Fiol}, Guilherme and Knisely, {Mitchell R.} and Keith Marsolo and Richesson, {Rachel L.} and Schlaeger, {Judith M.}",

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year = "2023",

month = jul,

doi = "10.1016/j.cct.2023.107238",

language = "English (US)",

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AU - Boyd, Andrew D.

AU - Gonzalez-Guarda, Rosa

AU - Lawrence, Katharine

AU - Patil, Crystal L.

AU - Ezenwa, Miriam O.

AU - O'Brien, Emily C.

AU - Paek, Hyung

AU - Braciszewski, Jordan M.

AU - Adeyemi, Oluwaseun

AU - Cuthel, Allison M.

AU - Darby, Juanita E.

AU - Zigler, Christina K.

AU - Ho, P. Michael

AU - Faurot, Keturah R.

AU - Staman, Karen

AU - Leigh, Jonathan W.

AU - Dailey, Dana L.

AU - Cheville, Andrea

AU - Del Fiol, Guilherme

AU - Knisely, Mitchell R.

AU - Marsolo, Keith

AU - Richesson, Rachel L.

AU - Schlaeger, Judith M.

PY - 2023/7

Y1 - 2023/7

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AB - Embedded pragmatic clinical trials (ePCTs) are conducted during routine clinical care and have the potential to increase knowledge about the effectiveness of interventions under real world conditions. However, many pragmatic trials rely on data from the electronic health record (EHR) data, which are subject to bias from incomplete data, poor data quality, lack of representation from people who are medically underserved, and implicit bias in EHR design. This commentary examines how the use of EHR data might exacerbate bias and potentially increase health inequities. We offer recommendations for how to increase generalizability of ePCT results and begin to mitigate bias to promote health equity.

KW - Community engagement

KW - Health equity

KW - Health literacy

KW - Patient-reported outcomes

KW - Social determinants of health

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JO - Contemporary Clinical Trials

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Equity and bias in electronic health records data

Abstract

Keywords

ASJC Scopus subject areas

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