Characterizing bias due to differential exposure ascertainment in electronic health record data

The objective of this paper was to explore the bias a nd efficiency of these three analytic approaches across a broad range of scenarios motivated by a study of the association between chronic hyperglycemia and 5-year mortality in an EHR-derived cohort of colon cancer survivors. We found that the best available approach tended to mitigate inefficiency and selection bias resulting from exclusion while suffering from less information bias than the common data approach. However, bias in all three approaches can be severe, particularly when both selection bias and information bias are present. When risk of either of these biases is judged to be more than moderate, EHR-based analyses may lead to erroneous conclusions.
Source: Health Services and Outcomes Research Methodology - Category: Statistics Source Type: research