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. 2023 Jul:130:107238.
doi: 10.1016/j.cct.2023.107238. Epub 2023 May 22.

Equity and bias in electronic health records data

Andrew D Boyd  1 , Rosa Gonzalez-Guarda  2 , Katharine Lawrence  3 , Crystal L Patil  4 , Miriam O Ezenwa  5 , Emily C O'Brien  6 , Hyung Paek  7 , Jordan M Braciszewski  8 , Oluwaseun Adeyemi  9 , Allison M Cuthel  9 , Juanita E Darby  4 , Christina K Zigler  10 , P Michael Ho  11 , Keturah R Faurot  12 , Karen Staman  10 , Jonathan W Leigh  4 , Dana L Dailey  13 , Andrea Cheville  14 , Guilherme Del Fiol  15 , Mitchell R Knisely  2 , Keith Marsolo  6 , Rachel L Richesson  16 , Judith M Schlaeger  4
Affiliations

Equity and bias in electronic health records data

Andrew D Boyd et al. Contemp Clin Trials. 2023 Jul.

Abstract

Embedded pragmatic clinical trials (ePCTs) are conducted during routine clinical care and have the potential to increase knowledge about the effectiveness of interventions under real world conditions. However, many pragmatic trials rely on data from the electronic health record (EHR) data, which are subject to bias from incomplete data, poor data quality, lack of representation from people who are medically underserved, and implicit bias in EHR design. This commentary examines how the use of EHR data might exacerbate bias and potentially increase health inequities. We offer recommendations for how to increase generalizability of ePCT results and begin to mitigate bias to promote health equity.

Keywords: Community engagement; Health equity; Health literacy; Patient-reported outcomes; Social determinants of health.

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Conflict of interest statement

Declaration of Competing Interest ECO Reports grants to her institution from Pfizer, BMS, and Novartis. KM reports grants and contracts to his institution from Novartis, Amgen, Seqirus, Genentech, BMS, and Boehringer Ingelheim. ADB reports grants from Alike Health, travel from Microsoft. All other authors have nothing to disclose.

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