An Empirical Study for Impacts of Measurement Errors on EHR based Association Studies.

Over the last decade, Electronic Health Records (EHR) systems have been increasingly implemented at US hospitals. Despite their great potential, the complex and uneven nature of clinical documentation and data quality brings additional challenges for analyzing EHR data. A critical challenge is the information bias due to the measurement errors in outcome and covariates. We conducted empirical studies to quantify the impacts of the information bias on association study. Specifically, we designed our simulation studies based on the characteristics of the Electronic Medical Records and Genomics (eMERGE) Network. Through simulation studies, we quantified the loss of power due to misclassifications in case ascertainment and measurement errors in covariate status extraction, with respect to different levels of misclassification rates, disease prevalence, and covariate frequencies. These empirical findings can inform investigators for better understanding of the potential power loss due to misclassification and measurement errors under a variety of conditions in EHR based association studies.