Challenges and Opportunities for Using Big Health Care Data to Advance Medical Science and Public Health

Am J Epidemiol. 2019 May 1;188(5):851-861. doi: 10.1093/aje/kwy292.

Abstract

Methodological advancements in epidemiology, biostatistics, and data science have strengthened the research world's ability to use data captured from electronic health records (EHRs) to address pressing medical questions, but gaps remain. We describe methods investments that are needed to curate EHR data toward research quality and to integrate complementary data sources when EHR data alone are insufficient for research goals. We highlight new methods and directions for improving the integrity of medical evidence generated from pragmatic trials, observational studies, and predictive modeling. We also discuss needed methods contributions to further ease data sharing across multisite EHR data networks. Throughout, we identify opportunities for training and for bolstering collaboration among subject matter experts, methodologists, practicing clinicians, and health system leaders to help ensure that methods problems are identified and resulting advances are translated into mainstream research practice more quickly.

Keywords: big data; data privacy; data quality; electronic health records; pragmatic clinical trials; predictive modeling; privacy-protecting analyses; retrospective cohort studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Big Data*
  • Biostatistics / methods*
  • Clinical Trials as Topic / methods
  • Comparative Effectiveness Research / methods
  • Confidentiality / standards
  • Cooperative Behavior
  • Data Accuracy
  • Data Anonymization / standards
  • Electronic Health Records / statistics & numerical data*
  • Epidemiologic Methods
  • Epidemiology / organization & administration
  • Humans
  • Information Dissemination
  • Interprofessional Relations
  • Medicine / statistics & numerical data*
  • Multicenter Studies as Topic / methods
  • Multicenter Studies as Topic / standards
  • Observational Studies as Topic / methods
  • Public Health*
  • Retrospective Studies
  • United States