Electronic Medical Records Can Be Used to Test Drug Efficacy

Researchers from the University of Pennsylvania (UPenn) have discovered that electronic medical records (EMR) can be used as a test for the efficacy of treatments for disease.

Richard Tannen, MD, professor of medicine at the University of Pennsylvania School of Medicine, analyzed patient data from EMR databases to obtain information when evaluating drug therapies. Tannen and his fellow researchers used information from six previously performed, randomized trials with 17 measured outcomes and compared them with the UK general practice research database.

The researchers gauged treatment efficacy by the prevalence of cardiovascular outcomes like stroke, heart attack, and death. After adjusting for differences in the treated and untreated groups, they found no differences in the database outcomes as compared to the random clinical trials in nine of the 17 outcomes.

For the other eight results, the researchers used a new biostatistical method that controlled for differences between the treated and untreated groups in the time before the study began. These methods allowed researchers to show that “there were no differences between the outcomes in the EMR database study compared to the randomized clinical trials.”

“Our findings show that if you do studies using EMR databases and you conduct analyses using new biostatistical methods we developed, we get results that are valid,” Tannen said in a UPenn news release. “That’s the real message of our paper — that this can work.”

The large EMR databases that contain compiled medical information could one day allow for the study of groups that reflect the entire population, not just participants of clinical trials, and move away from studies that are too costly or unethical for clinical trials.

However, the researchers also recognized that these databases have observational information, which critics say does not offer the same control of randomized trials.

Though Tannen says that using EMR databases in the US to analyze the efficacy of treatments would take more than 10 years of data, the results of this study should serve as a catalyst for other researchers to explore the accuracy of EMR database information.

“Our study cautiously, yet strongly, suggests that enormous amounts of information within electronic medical records can be used to expand evidence of how we should or shouldn’t manage health care,” Tannen said in the UPenn release. Click here to read the full-text version of the study published in the British Medical Journal.

specialty: primary care