Informatics Spotlight

Informatics Spotlight

Utilization of a clinical data warehouse for use as a primary data source for clinical studies

Shanmuga Sundaram, Chris Schafer, Todd Gress and Alfred Cecchetti


Institutional data warehouse of all medical information is valuable to improve patient care, facilitate quality assurance and cost/benefit analysis. It is essential for clinical outcomes research within and between health science centers. Thus, the National Institutes of Health has made formation of an i2b2-based clinical data warehouse a key component of funding for clinical and translational science institutes in this country. Recently at Marshall a data warehouse of all clinical and billing information at Cabell Huntington Hospital and Marshall Health was created. It is currently not clear whether a warehouse may be exclusively used as source data without correlation with medical records.


Hepatitis-C patients with anemia have more GI tract pathology as etiology for the anemia.


Query from warehouse patients who had liver function tests (LFTs), hepatitis-C, anemia, and endoscopic procedures. Ascertain from medical records if the Marshall data warehouse may be used as a primary source for retrospective clinical studies. Results Between 2010 and 2015, 77,366 patients had LFTs and 37,272 were abnormal and 40,094 were normal. Hepatitis-C was more likely present in patients with abnormal LFTs (2.7 vs 0.4%). Irrespective of LFTs, Hepatitis-C patients had more anemia (75 vs 62% abnormal LFTs and 60 vs 37% normal LFTs). We will determine the presence of GI-tract pathology in each subgroup. Ultimately, we plan to determine the minimum number of randomly selected subgroup patients necessary to validate warehouse-based data with 95% confidence using the individual patient record.


The results of this study will demonstrate that warehouse may be used as primary source for clinical retrospective studies with only a small sampling validation of source data. Secondarily this study will validate the warehouse at least for this
particular patient group, which will greatly facilitate clinical research at Marshall.