Analyses of preventive care measures with incomplete historical data in electronic medical records: An example from colorectal cancer screening

Yingye Zheng, Douglas A. Corley, Chyke Doubeni, Ethan Halm, Susan M. Shortreed, William E. Barlow, Ann Zauber, Tor Devin Tosteson, Jessica Chubak

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

The calculation of quality of care measures based on electronic medical records (EMRs) may be inaccurate because of incomplete capture of past services. We evaluate the influence of different statistical approaches for calculating the proportion of patients who are up-to-date for a preventive service, using the example of colorectal cancer (CRC) screening. We propose an extension of traditional mixture models to account for the uncer-tainty in compliance which is further complicated by the choice of various screening modalities with different recommended screening intervals. We conducted simulation studies to compare various statistical approaches and demonstrated that the proposed method can alleviate bias when individuals with complete prior medical history information were not representative of the targeted population. The method is motivated by and applied to data from the National Cancer Institute–funded consortium Population-Based Research Optimizing Screening through Personalized Regiments (PROSPR). Findings from the application are important for the evaluation of appropriate use of preventive care and provide a novel tool for dealing with similar analytical challenges with EMR data in broad settings.

Original languageEnglish (US)
Pages (from-to)1030-1044
Number of pages15
JournalAnnals of Applied Statistics
Volume14
Issue number2
DOIs
StatePublished - 2020

Keywords

  • Cancer screening
  • EMR data
  • Event-time analysis
  • Mixture model

ASJC Scopus subject areas

  • Statistics and Probability
  • Modeling and Simulation
  • Statistics, Probability and Uncertainty

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    Zheng, Y., Corley, D. A., Doubeni, C., Halm, E., Shortreed, S. M., Barlow, W. E., Zauber, A., Tosteson, T. D., & Chubak, J. (2020). Analyses of preventive care measures with incomplete historical data in electronic medical records: An example from colorectal cancer screening. Annals of Applied Statistics, 14(2), 1030-1044. https://doi.org/10.1214/20-AOAS1342