Faraz S Ahmad1, Cheeling Chan1, Marc B Rosenman1, Wendy S Post1, Daniel G Fort1, Philip Greenland1, Kiang J Liu1, Abel N Kho1, Norrina B Allen2. 1. From Division of Epidemiology, Department of Preventive Medicine (F.S.A., C.C., P.G., K.J.L., N.B.A.); Division of Cardiology, Department of Medicine (F.S.A., P.G.); Department of Pediatrics (M.B.R.); The Center for Health Information Partnerships (CHiP), Institute of Public Health & Medicine (M.B.R., A.N.K.); Division of Health and Biomedical Informatics, Department of Preventive Medicine (D.G.F.); Division of General Internal Medicine and Geriatrics, Department of Medicine (A.N.K.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (W.S.P.). 2. From Division of Epidemiology, Department of Preventive Medicine (F.S.A., C.C., P.G., K.J.L., N.B.A.); Division of Cardiology, Department of Medicine (F.S.A., P.G.); Department of Pediatrics (M.B.R.); The Center for Health Information Partnerships (CHiP), Institute of Public Health & Medicine (M.B.R., A.N.K.); Division of Health and Biomedical Informatics, Department of Preventive Medicine (D.G.F.); Division of General Internal Medicine and Geriatrics, Department of Medicine (A.N.K.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.); Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (W.S.P.). norrina-allen@northwestern.edu.
Abstract
BACKGROUND: Understanding the validity of data from electronic data research networks is critical to national research initiatives and learning healthcare systems for cardiovascular care. Our goal was to evaluate the degree of agreement of electronic data research networks in comparison with data collected by standardized research approaches in a cohort study. METHODS: We linked individual-level data from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort, with HealthLNK, a 2006 to 2012 database of electronic health records from 6 Chicago health systems. To evaluate the correlation and agreement of blood pressure in HealthLNK in comparison with in-person MESA examinations, and body mass index in HealthLNK in comparison with MESA, we used Pearson correlation coefficients and Bland-Altman plots. Using diagnoses in MESA as the criterion standard, we calculated the performance of HealthLNK for hypertension, obesity, and diabetes mellitus diagnosis by using International Classification of Diseases, Ninth Revision codes and clinical data. We also identified potential myocardial infarctions, strokes, and heart failure events in HealthLNK and compared them with adjudicated events in MESA. RESULTS: Of the 1164 MESA participants enrolled at the Chicago Field Center, 802 (68.9%) participants had data in HealthLNK. The correlation was low for systolic blood pressure (0.39; P<0.0001). In comparison with MESA, HealthLNK overestimated systolic blood pressure by 6.5 mm Hg (95% confidence interval, 4.2-7.8). There was a high correlation between body mass index in MESA and HealthLNK (0.94; P<0.0001). HealthLNK underestimated body mass index by 0.3 kg/m2 (95% confidence interval, -0.4 to -0.1). With the use of International Classification of Diseases, Ninth Revision codes and clinical data, the sensitivity and specificity of HealthLNK queries for hypertension were 82.4% and 59.4%, for obesity were 73.0% and 89.8%, and for diabetes mellitus were 79.8% and 93.3%. In comparison with adjudicated cardiovascular events in MESA, the concordance rates for myocardial infarction, stroke, and heart failure were, respectively, 41.7% (5/12), 61.5% (8/13), and 62.5% (10/16). CONCLUSIONS: These findings illustrate the limitations and strengths of electronic data repositories in comparison with information collected by traditional standardized epidemiological approaches for the ascertainment of cardiovascular risk factors and events.
BACKGROUND: Understanding the validity of data from electronic data research networks is critical to national research initiatives and learning healthcare systems for cardiovascular care. Our goal was to evaluate the degree of agreement of electronic data research networks in comparison with data collected by standardized research approaches in a cohort study. METHODS: We linked individual-level data from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort, with HealthLNK, a 2006 to 2012 database of electronic health records from 6 Chicago health systems. To evaluate the correlation and agreement of blood pressure in HealthLNK in comparison with in-personMESA examinations, and body mass index in HealthLNK in comparison with MESA, we used Pearson correlation coefficients and Bland-Altman plots. Using diagnoses in MESA as the criterion standard, we calculated the performance of HealthLNK for hypertension, obesity, and diabetes mellitus diagnosis by using International Classification of Diseases, Ninth Revision codes and clinical data. We also identified potential myocardial infarctions, strokes, and heart failure events in HealthLNK and compared them with adjudicated events in MESA. RESULTS: Of the 1164 MESAparticipants enrolled at the Chicago Field Center, 802 (68.9%) participants had data in HealthLNK. The correlation was low for systolic blood pressure (0.39; P<0.0001). In comparison with MESA, HealthLNK overestimated systolic blood pressure by 6.5 mm Hg (95% confidence interval, 4.2-7.8). There was a high correlation between body mass index in MESA and HealthLNK (0.94; P<0.0001). HealthLNK underestimated body mass index by 0.3 kg/m2 (95% confidence interval, -0.4 to -0.1). With the use of International Classification of Diseases, Ninth Revision codes and clinical data, the sensitivity and specificity of HealthLNK queries for hypertension were 82.4% and 59.4%, for obesity were 73.0% and 89.8%, and for diabetes mellitus were 79.8% and 93.3%. In comparison with adjudicated cardiovascular events in MESA, the concordance rates for myocardial infarction, stroke, and heart failure were, respectively, 41.7% (5/12), 61.5% (8/13), and 62.5% (10/16). CONCLUSIONS: These findings illustrate the limitations and strengths of electronic data repositories in comparison with information collected by traditional standardized epidemiological approaches for the ascertainment of cardiovascular risk factors and events.
Authors: Jane S Saczynski; Susan E Andrade; Leslie R Harrold; Jennifer Tjia; Sarah L Cutrona; Katherine S Dodd; Robert J Goldberg; Jerry H Gurwitz Journal: Pharmacoepidemiol Drug Saf Date: 2012-01 Impact factor: 2.890
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Maarten L Simoons; Bernard R Chaitman; Harvey D White; Hugo A Katus; Bertil Lindahl; David A Morrow; Peter M Clemmensen; Per Johanson; Hanoch Hod; Richard Underwood; Jeroen J Bax; Robert O Bonow; Fausto Pinto; Raymond J Gibbons; Keith A Fox; Dan Atar; L Kristin Newby; Marcello Galvani; Christian W Hamm; Barry F Uretsky; Ph Gabriel Steg; William Wijns; Jean-Pierre Bassand; Phillippe Menasché; Jan Ravkilde; E Magnus Ohman; Elliott M Antman; Lars C Wallentin; Paul W Armstrong; Maarten L Simoons; James L Januzzi; Markku S Nieminen; Mihai Gheorghiade; Gerasimos Filippatos; Russell V Luepker; Stephen P Fortmann; Wayne D Rosamond; Dan Levy; David Wood; Sidney C Smith; Dayi Hu; José-Luis Lopez-Sendon; Rose Marie Robertson; Douglas Weaver; Michal Tendera; Alfred A Bove; Alexander N Parkhomenko; Elena J Vasilieva; Shanti Mendis Journal: Circulation Date: 2012-08-24 Impact factor: 29.690
Authors: Katherine M Newton; Peggy L Peissig; Abel Ngo Kho; Suzette J Bielinski; Richard L Berg; Vidhu Choudhary; Melissa Basford; Christopher G Chute; Iftikhar J Kullo; Rongling Li; Jennifer A Pacheco; Luke V Rasmussen; Leslie Spangler; Joshua C Denny Journal: J Am Med Inform Assoc Date: 2013-03-26 Impact factor: 4.497
Authors: Robert J Mentz; L Kristin Newby; Ben Neely; Joseph E Lucas; Sean D Pokorney; Meena P Rao; Larry R Jackson; Maria V Grau-Sepulveda; Michelle M Smerek; Pamela Barth; Charlotte L Nelson; Michael J Pencina; Bimal R Shah Journal: J Am Coll Cardiol Date: 2016-05-24 Impact factor: 24.094
Authors: Mark A Hlatky; Pamela S Douglas; Nakela L Cook; Barbara Wells; Emelia J Benjamin; Kay Dickersin; David C Goff; Alan T Hirsch; Elaine M Hylek; Eric D Peterson; Véronique L Roger; Joseph V Selby; James E Udelson; Michael S Lauer Journal: J Am Coll Cardiol Date: 2012-07-11 Impact factor: 24.094
Authors: Mark A Hlatky; Roberta M Ray; Dale R Burwen; Karen L Margolis; Karen C Johnson; Anna Kucharska-Newton; JoAnn E Manson; Jennifer G Robinson; Monika M Safford; Matthew Allison; Themistocles L Assimes; Anthony A Bavry; Jeffrey Berger; Rhonda M Cooper-DeHoff; Susan R Heckbert; Wenjun Li; Simin Liu; Lisa W Martin; Marco V Perez; Hilary A Tindle; Wolfgang C Winkelmayer; Marcia L Stefanick Journal: Circ Cardiovasc Qual Outcomes Date: 2014-01-07
Authors: Elie S Al Kazzi; Brandyn Lau; Tianjing Li; Eric B Schneider; Martin A Makary; Susan Hutfless Journal: PLoS One Date: 2015-11-04 Impact factor: 3.240
Authors: Paul Muntner; Paula T Einhorn; William C Cushman; Paul K Whelton; Natalie A Bello; Paul E Drawz; Beverly B Green; Daniel W Jones; Stephen P Juraschek; Karen L Margolis; Edgar R Miller; Ann Marie Navar; Yechiam Ostchega; Michael K Rakotz; Bernard Rosner; Joseph E Schwartz; Daichi Shimbo; George S Stergiou; Raymond R Townsend; Jeff D Williamson; Jackson T Wright; Lawrence J Appel Journal: J Am Coll Cardiol Date: 2019-01-29 Impact factor: 24.094
Authors: Lindsay R Pool; Hongyan Ning; John Wilkins; Donald M Lloyd-Jones; Norrina B Allen Journal: JAMA Cardiol Date: 2018-11-01 Impact factor: 14.676
Authors: Sameer Prasada; Adovich Rivera; Arvind Nishtala; Anna E Pawlowski; Arjun Sinha; Joshua D Bundy; Simran A Chadha; Faraz S Ahmad; Sadiya S Khan; Chad Achenbach; Frank J Palella; Rosalind Ramsey-Goldman; Yvonne C Lee; Jonathan I Silverberg; Babafemi O Taiwo; Sanjiv J Shah; Donald M Lloyd-Jones; Matthew J Feinstein Journal: JACC Heart Fail Date: 2020-04-08 Impact factor: 12.035
Authors: Jordan B Strom; Kamil F Faridi; Neel M Butala; Yuansong Zhao; Hector Tamez; Linda R Valsdottir; J Matthew Brennan; Changyu Shen; Jeffrey J Popma; Dhruv S Kazi; Robert W Yeh Journal: Circulation Date: 2020-05-21 Impact factor: 29.690
Authors: Faraz S Ahmad; Iben M Ricket; Bradley G Hammill; Lisa Eskenazi; Holly R Robertson; Lesley H Curtis; Cecilia D Dobi; Saket Girotra; Kevin Haynes; Jorge R Kizer; Sunil Kripalani; Mathew T Roe; Christianne L Roumie; Russ Waitman; W Schuyler Jones; Mark G Weiner Journal: Circ Cardiovasc Qual Outcomes Date: 2020-05-29
Authors: Emily C O'Brien; Shuang Li; Laine Thomas; Tracy Y Wang; Matthew T Roe; Eric D Peterson Journal: Clin Cardiol Date: 2018-09-22 Impact factor: 2.882
Authors: Jordan B Strom; Hector Tamez; Yuansong Zhao; Linda R Valsdottir; Jeptha Curtis; J Matthew Brennan; Changyu Shen; Jeffrey J Popma; Laura Mauri; Robert W Yeh Journal: Am Heart J Date: 2019-03-06 Impact factor: 4.749
Authors: Jonathan D Mosley; Mark D Benson; J Gustav Smith; Olle Melander; Debby Ngo; Christian M Shaffer; Jane F Ferguson; Matthew S Herzig; Catherine A McCarty; Christopher G Chute; Gail P Jarvik; Adam S Gordon; Melody R Palmer; David R Crosslin; Eric B Larson; David S Carrell; Iftikhar J Kullo; Jennifer A Pacheco; Peggy L Peissig; Murray H Brilliant; Terrie E Kitchner; James G Linneman; Bahram Namjou; Marc S Williams; Marylyn D Ritchie; Kenneth M Borthwick; Krzysztof Kiryluk; Frank D Mentch; Patrick M Sleiman; Elizabeth W Karlson; Shefali S Verma; Yineng Zhu; Ramachandran S Vasan; Qiong Yang; Josh C Denny; Dan M Roden; Robert E Gerszten; Thomas J Wang Journal: Circulation Date: 2018-11-27 Impact factor: 29.690
Authors: Olive Tang; Stephen P Juraschek; Lawrence J Appel; Lisa A Cooper; Jeanne Charleston; Romsai T Boonyasai; Kathryn A Carson; Hsin-Chieh Yeh; Edgar R Miller Journal: J Clin Hypertens (Greenwich) Date: 2018-11-07 Impact factor: 3.738