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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2022

Open Access 01-12-2022 | Human Papillomavirus | Research

The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control

Authors: Sarah Conderino, Stefanie Bendik, Thomas B. Richards, Claudia Pulgarin, Pui Ying Chan, Julie Townsend, Sungwoo Lim, Timothy R. Roberts, Lorna E. Thorpe

Published in: BMC Medical Informatics and Decision Making | Issue 1/2022

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Abstract

Introduction

State cancer prevention and control programs rely on public health surveillance data to set objectives to improve cancer prevention and control, plan interventions, and evaluate state-level progress towards achieving those objectives. The goal of this project was to evaluate the validity of using electronic health records (EHRs) based on common data model variables to generate indicators for surveillance of cancer prevention and control for these public health programs.

Methods

Following the methodological guidance from the PRISMA Extension for Scoping Reviews, we conducted a literature scoping review to assess how EHRs are used to inform cancer surveillance. We then developed 26 indicators along the continuum of the cascade of care, including cancer risk factors, immunizations to prevent cancer, cancer screenings, quality of initial care after abnormal screening results, and cancer burden. Indicators were calculated within a sample of patients from the New York City (NYC) INSIGHT Clinical Research Network using common data model EHR data and were weighted to the NYC population using post-stratification. We used prevalence ratios to compare these estimates to estimates from the raw EHR of NYU Langone Health to assess quality of information within INSIGHT, and we compared estimates to results from existing surveillance sources to assess validity.

Results

Of the 401 identified articles, 15% had a study purpose related to surveillance. Our indicator comparisons found that INSIGHT EHR-based measures for risk factor indicators were similar to estimates from external sources. In contrast, cancer screening and vaccination indicators were substantially underestimated as compared to estimates from external sources. Cancer screenings and vaccinations were often recorded in sections of the EHR that were not captured by the common data model. INSIGHT estimates for many quality-of-care indicators were higher than those calculated using a raw EHR.

Conclusion

Common data model EHR data can provide rich information for certain indicators related to the cascade of care but may have substantial biases for others that limit their use in informing surveillance efforts for cancer prevention and control programs.
Appendix
Available only for authorised users
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Metadata
Title
The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control
Authors
Sarah Conderino
Stefanie Bendik
Thomas B. Richards
Claudia Pulgarin
Pui Ying Chan
Julie Townsend
Sungwoo Lim
Timothy R. Roberts
Lorna E. Thorpe
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2022
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-022-01831-8

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