Study Results from Q. Ma and Colleagues Broaden Understanding of Electronic Medical Records (Administrative claims data to support pragmatic clinical trial outcome ascertainment on cardiovascular health)

2019 MAY 28 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- New research on Information Technology - Electronic Medical Records is the subject of a report. According to news reporting originating in Wilmington, United States, by NewsRx journalists, research stated, “Health plan administrative claims data present a cost-effective complement to traditional trial-specific ascertainment of clinical events typically conducted through patient report or a single health system electronic health record. We aim to demonstrate the value of health plan claims data in improving the capture of endpoints in longitudinal pragmatic clinical trials.”

Financial support for this research came from Patient-Centered Outcomes Research Institute.

The news reporters obtained a quote from the research, “This retrospective cohort study paralleled the design of the ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness) trial designed to compare the effectiveness of two doses of aspirin. We applied the ADAPTABLE identification query in claims data from Anthem, an American health insurance company, and identified health plan members who met the ADAPTABLE trial criteria. Among the ADAPTABLE eligible members, we selected overlapping members with PCORnet Clinical Data Research Networks in the 2 years prior to the index date (1 April 2014). PCORnet Clinical Data Research Networks consist of network partners (or healthcare systems) that store their electronic health record data in the same format to support multi-institutional research. ADAPTABLE outcome events-cardiovascular hospitalizations including admissions for myocardial infarction, stroke, or cardiac procedures; hospitalizations for major bleeding; and in-hospital deaths-were evaluated for a 2-year follow-up period. Events were classified as within or outside PCORnet Clinical Data Research Networks using facility identifiers affiliated with each hospital stay. Patient characteristics were examined with descriptive statistics, and incidence rates were reported for available Clinical Data Research Networks and claims data. Among 884,311 ADAPTABLE eligible health plan members, 11,101 patients overlapped with PCORnet Clinical Data Research Networks. Average age was 70 years, 71% were male, and average follow-up was 20.7 months. Patients had 1521 cardiovascular hospitalizations (571 (37.5%) occurred outside PCORnet Clinical Data Research Networks), 710 for major bleeding (296 (41.7%) outside PCORnet Clinical Data Research Networks), and 196 in-hospital deaths (67 (34.2%) outside PCORnet Clinical Data Research Networks). Incidence rates (events per1000 patient-months) differed between available network partners and claims data: cardiovascular hospitalizations, 4.1 (95% confidence interval: 3.9, 4.4) versus 6.6 (95% confidence interval: 6.3, 7.0), major bleeding, 1.8 (95% confidence interval: 1.6, 2.0) versus 3.1 (95% confidence interval: 2.9, 3.3), and in-hospital death, 0.56 (95% confidence interval: 0.47, 0.67) versus 0.85 (95% confidence interval: 0.74, 0.98), respectively. This study demonstrated the value of supplementing longitudinal site-based clinical studies with administrative claims data.”

According to the news reporters, the research concluded: “Our results suggest that claims data together with network partner electronic health record data constitute an effective vehicle to capture patient outcomes since >30% of patients have non-fatal and fatal events outside of enrolling sites.”

For more information on this research see: Administrative claims data to support pragmatic clinical trial outcome ascertainment on cardiovascular health. Clinical Trials, 2019;():174077451984685. Clinical Trials can be contacted at: SAGE Publications, USA , 2455 Teller Road, Thousand Oaks, CA 91320, USA. (Sage Publications - http://www.sagepub.com/; Clinical Trials - ctj.sagepub.com)

Our news correspondents report that additional information may be obtained by contacting Q. Ma, 1 HealthCore Inc., Wilmington, DE, United States. Additional authors for this research include H. Chung, S. Shambhu, M. Roe, M. Cziraky, W.S. Jones and K. Haynes.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1177/1740774519846853. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher of the journal Clinical Trials can be contacted at: SAGE Publications, USA , 2455 Teller Road, Thousand Oaks, CA 91320, USA.

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