Table 1.
Comparing the study cohort with high vs. low EHR-continuity (unadjusted analyses)
| Hospital | Empirical example | EHR-continuity | Data | Exposure, event #/IR per 100 PY | Reference, event #/IR per 100 PY | Crude HR (95% CI) | % outcome event captured by EHR | % bias |
|---|---|---|---|---|---|---|---|---|
| System 1 | A-STO | Top 25% | EHR only | 43/27.12 | 16/12.27 | 2.20 (1.27, 3.84) | 94% | 0% |
| EHR+ claims | 46/29.04 | 17/13.04 | 2.22 (1.30, 3.81) | |||||
| Top 25–50% | EHR only | 47/32.16 | 21/17.52 | 1.83 (1.14, 2.94) | 96% | 1% | ||
| EHR+ claims | 49/33.52 | 22/18.36 | 1.82 (1.14, 2.90) | |||||
| Top 50–75% | EHR only | 46/39.87 | <11/8.53 | 4.63 (2.22, 9.68) | 82% | 41% | ||
| EHR+ claims | 53/46.08 | 13/13.89 | 3.29 (1.81, 5.98) | |||||
| Lower 25% | EHR only | 18/20.24 | <11/9.23 | 2.19 (0.95, 5.02) | 81% | 18% | ||
| EHR+ claims | 21/23.65 | 11/12.72 | 1.85 (0.89, 3.84) | |||||
| A-LTO | Top 25% | EHR only | 26/1.57 | 18/1.31 | 1.20 (0.72, 2.01) | 70% | 13% | |
| EHR+ claims | 39/2.37 | 24/1.75 | 1.35 (0.86, 2.12) | |||||
| Top 25–50% | EHR only | 22/1.50 | 13/1.06 | 1.40 (0.74, 2.66) | 55% | 6% | ||
| EHR+ claims | 41/2.80 | 23/1.88 | 1.48 (0.90, 2.42) | |||||
| Top 50–75% | EHR only | 21/1.79 | <11/0.41 | 4.31 (1.61, 11.51) | 38% | 145% | ||
| EHR+ claims | 45/3.89 | 21/2.19 | 1.76 (1.08, 2.89) | |||||
| Lower 25% | EHR only | <11/0.44 | <11/0.23 | 1.95 (0.36, 10.68) | 21% | 41% | ||
| EHR+ claims | 17/1.89 | 12/1.36 | 1.39 (0.66, 2.90) | |||||
| GN-LTO | Top 25% | EHR only | 730/9.97 | 299/4.22 | 2.34 (2.05, 2.68) | 56% | 11% | |
| EHR+ claims | 1329/18.98 | 503/7.19 | 2.59 (2.33, 2.87) | |||||
| Top 25–50% | EHR only | 427/6.93 | 168/2.41 | 2.83 (2.37, 3.38) | 29% | 6% | ||
| EHR+ claims | 1410/24.86 | 612/9.04 | 2.68 (2.43, 2.94) | |||||
| Top 50–75% | EHR only | 173/4.19 | 78/1.25 | 3.29 (2.53, 4.28) | 18% | 20% | ||
| EHR+ claims | 880/23.26 | 497/8.19 | 2.75 (2.46, 3.07) | |||||
| Lower 25% | EHR only | 146/2.83 | 32/0.68 | 4.04 (2.73, 5.98) | 13% | 66% | ||
| EHR+ claims | 1015/21.29 | 381/8.40 | 2.44 (2.16, 2.76) | |||||
| GG-LTO | Top 25% | EHR only | 699/10.52 | 244/10.58 | 1.00 (0.87, 1.14) | 56% | 1% | |
| EHR+ claims | 1245/19.59 | 438/19.85 | 0.99 (0.90, 1.10) | |||||
| Top 25–50% | EHR only | 390/6.81 | 106/6.23 | 1.10 (0.89, 1.35) | 33% | 2% | ||
| EHR+ claims | 1189/22.26 | 330/20.67 | 1.08 (0.96, 1.21) | |||||
| Top 50–75% | EHR only | 238/4.63 | 76/6.08 | 0.77 (0.60, 0.98) | 21% | 8% | ||
| EHR+ claims | 1167/25.01 | 340/30.50 | 0.83 (0.74, 0.93) | |||||
| Lower 25% | EHR only | 149/2.83 | 16/1.49 | 1.90 (1.15, 3.14) | 14% | 61% | ||
| EHR+ claims | 1033/21.26 | 180/17.95 | 1.18 (1.01, 1.37) | |||||
| System 2 | A-STO | Top 25% | EHR only | 23/31.35 | <11/10.33 | 3.03 (1.28, 7.13) | 97% | 4% |
| EHR+ claims | 24/32.74 | <11/10.34 | 3.16 (1.35, 7.41) | |||||
| Top 25–50% | EHR only | 21/23.24 | <11/9.01 | 2.56 (1.17, 5.62) | 83% | 20% | ||
| EHR+ claims | 24/26.61 | 11/12.41 | 2.13 (1.07, 4.26) | |||||
| Top 50–75% | EHR only | 36/41.35 | 17/18.03 | 2.27 (1.29, 4.00) | 82% | 24% | ||
| EHR+ claims | 47/54.27 | 18/19.10 | 2.81 (1.65, 4.80) | |||||
| Lower 25% | EHR only | 24/24.24 | <11/8.74 | 2.74 (1.31, 5.72) | 72% | 37% | ||
| EHR+ claims | 36/36.58 | 11/9.62 | 3.75 (1.91, 7.38) | |||||
| A-LTO | Top 25% | EHR only | 11/1.39 | <11/0.83 | 1.67 (0.66, 4.25) | 63% | 29% | |
| EHR+ claims | 19/2.40 | <11/1.11 | 2.16 (0.98, 4.79) | |||||
| Top 25–50% | EHR only | 13/1.41 | <11/0.64 | 2.17 (0.86, 5.43) | 51% | 17% | ||
| EHR+ claims | 24/2.61 | 13/1.39 | 1.85 (0.96, 3.58) | |||||
| Top 50–75% | EHR only | 22/2.60 | 11/1.10 | 2.28 (1.11, 4.71) | 49% | 30% | ||
| EHR+ claims | 41/4.87 | 27/2.73 | 1.75 (1.08, 2.82) | |||||
| Lower 25% | EHR only | 15/1.53 | <11/0.33 | 4.60 (1.53, 13.79) | 31% | 128% | ||
| EHR+ claims | 38/3.93 | 23/1.88 | 2.02 (1.21, 3.39) | |||||
| GN-LTO | Top 25% | EHR only | 283/7.62 | 120/3.32 | 2.29 (1.85, 2.85) | 57% | 3% | |
| EHR+ claims | 494/13.68 | 218/6.11 | 2.23 (1.90, 2.62) | |||||
| Top 25–50% | EHR only | 307/6.12 | 108/2.16 | 2.79 (2.24, 3.48) | 30% | 30% | ||
| EHR+ claims | 929/19.71 | 434/8.96 | 2.15 (1.92, 2.41) | |||||
| Top 50–75% | EHR only | 184/4.79 | 58/1.10 | 4.25 (3.15, 5.75) | 17% | 79% | ||
| EHR+ claims | 881/25.05 | 518/10.17 | 2.37 (2.12, 2.64) | |||||
| Lower 25% | EHR only | 117/2.27 | 28/0.50 | 4.41 (2.88, 6.76) | 10% | 100% | ||
| EHR+ claims | 970/20.37 | 479/8.94 | 2.21 (1.97, 2.46) | |||||
| GG-LTO | Top 25% | EHR only | 260/8.00 | 117/9.10 | 0.88 (0.72, 1.09) | 59% | 0% | |
| EHR+ claims | 439/13.90 | 198/15.88 | 0.88 (0.76, 1.03) | |||||
| Top 25–50% | EHR only | 262/6.08 | 117/8.75 | 0.70 (0.58, 0.86) | 38% | 11% | ||
| EHR+ claims | 715/17.47 | 285/22.70 | 0.78 (0.69, 0.89) | |||||
| Top 50–75% | EHR only | 242/4.94 | 83/6.33 | 0.79 (0.63, 0.99) | 22% | 5% | ||
| EHR+ claims | 1111/24.74 | 354/30.00 | 0.83 (0.75, 0.93) | |||||
| Lower 25% | EHR only | 127/2.41 | 19/1.82 | 1.32 (0.82, 2.12) | 12% | 11% | ||
| EHR+ claims | 1009/20.75 | 169/17.30 | 1.19 (1.01, 1.39) |
EHR= electronic health records, IR=incidence rate, PY=person-years, HR = hazard ratio, CI= confidence interval, Ref= referent group
A-STO: comparing the effect of two Antibiotics on a short-term outcome
A-LTO: comparing the effect of two Antibiotics effect on a long-term outcome
GN-LTO: Comparing the effect of a Gastroprotective agent vs. non-use on a long-term outcome
GG-LTO: Comparing the effect of two Gastroprotective agents on a long-term outcome