Pediatric and family medicine tend to be far ahead of [otolaryngology] when it comes to population health because those providers are more interested in a prevention approach rather than a treatment approach. —Kevin Sykes, PhD, MPH
Explore This IssueOctober 2019
Data Quality Is Crucial
Huge troves of digitized data can reveal valuable information about patient populations, but researchers and clinicians must carefully evaluate the quality of available data. The proliferation of electronic medical records (EMRs) means that healthcare researchers have access to more data points than ever before, but experts call for caution. “Networked electronic health records are potentially a very powerful research tool, but we have to be careful in terms of how we collect, interpret, and analyze the data,” Dr. Smith said.
Hospitals, healthcare centers, and insurance companies maintain large databases of patient information, but much of that data is collected to satisfy payors’ requirements. “Most databases today are all actuarial designed,” said Chester Griffiths, MD, an otolaryngologist at Providence Saint John’s Health Center in Santa Monica, Calif.
Better sources of data include national health projects such as the National Cancer Institute’s Surveillance, Epidemiology, and End Result (SEER) database, which includes data from population-based cancer registries, and the National Cancer Database, which is jointly sponsored by the American College of Surgeons and the American Cancer Society and includes data on more than 70% of all newly diagnosed cancer cases in the United States. The All of Us Research Program, a National Institutes of Health effort to collect personal health and genomic information from one million Americans, will also produce tremendous quantities of valuable data.
Reviewing the data present in such large databases is a great way to generate hypotheses, said Dr. Sykes. However, additional data is usually necessary to test those hypotheses.
An analysis of the information contained in a database may reveal, for instance, that African American patients with oropharyngeal cancer typically experience poorer outcomes than white patients with the same type of cancer, despite identical treatment. “That’s good to know, but the data can’t tell us why,” Dr. Sykes said. “Is it because of systemic bias? Or is something genetic going on? Is there some other component of the disease itself that we don’t understand?”
Dr. Sykes frequently encourages the otolaryngologists in his department to add a population health focus to their research questions. “I ask them to think about what additional data points they might want to consider to make sure planned interventions are sensitive to particular populations, such as people that live further away or have less income,” Dr. Sykes said.