Electronic primary care, hospital, disease, and death records each miss 25 to 50 percent of MIs
WEDNESDAY, May 22 (HealthDay News) -- Electronic health records, including primary care and hospital records, and disease and mortality registers, each missed 25 to 50 percent of myocardial infarction (MI) events recorded between 2003 and 2009 in patients in England, according to research published online May 21 in BMJ.
Emily Herrett, Ph.D., of the London School of Hygiene and Tropical Medicine, and colleagues examined electronic records from January 2003 through March 2009 to identify 21,482 patients in England who had an acute MI. Primary care, hospital admissions, myocardial infarction registry, and cause-specific mortality data were reviewed from four prospectively collected, linked electronic health record sources within the National Health Service.
The researchers found that 31.0 percent of patients with non-fatal acute MI were recorded in the three sources for primary care, hospital admissions, and disease registry data, and 63.9 percent were recorded in at least two of these sources. Using one source compared with all three sources underestimated the crude incidence of acute MI by 25 to 50 percent. Compared with the diagnosis of acute MI as defined in the disease registry, the positive predictive value of the diagnosis of acute MI recorded in other data sources was 92.2 percent for primary care and 91.5 percent for hospital admissions.
"Each data source missed a substantial proportion (25 to 50 percent) of myocardial infarction events," the authors write. "Failure to use linked electronic health records from primary care, hospital care, disease registry, and death certificates may lead to biased estimates of the incidence and outcome of myocardial infarction."
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