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.