{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:02:27Z","timestamp":1788498147556,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Electronic medical records (EMRs) are important for rapidly compiling information to determine disease characteristics (eg, symptoms) and risk factors (eg, underlying comorbidities, medications) for disease-related outcomes. To assess EMR data accuracy, agreement between EMR abstractions and patient interviews was evaluated. Symptoms, medical history, and medication use among patients with COVID-19 collected from EMRs and patient interviews were compared using overall agreement (ie, same answer in EMR and interview), reported agreement (yes answer in both EMR and interview among those who reported yes in either), and \u03ba statistics. Overall, patients reported more symptoms in interviews than in EMR abstractions. Overall agreement was high (\u226550% for 20 of 23 symptoms), but only subjective fever and dyspnea had reported agreement of \u226550%. The \u03ba statistics for symptoms were generally low. Reported medical conditions had greater agreement with all condition categories (n = 10 of 10) having \u226550% overall agreement and half (n = 5 of 10) having \u226550% reported agreement. More nonprescription medications were reported in interviews than in EMR abstractions, leading to low reported agreement (28%). Discordance was observed for symptoms, medical history, and medication use between EMR abstractions and patient interviews. Investigations using EMRs to describe clinical characteristics and identify risk factors should consider the potential for incomplete data, particularly for symptoms and medications.<\/jats:p>","DOI":"10.1093\/aje\/kwae079","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T11:22:28Z","timestamp":1716376948000},"page":"1442-1450","source":"Crossref","is-referenced-by-count":3,"title":["The role and limitations of electronic medical records versus patient interviews for determining symptoms of, underlying comorbidities of, and medication use by patients with COVID-19"],"prefix":"10.1093","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8483-6459","authenticated-orcid":false,"given":"Raymond A","family":"Soto","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, , Atlanta, GA 30345,","place":["United States"]},{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-1933","authenticated-orcid":false,"given":"Grace M","family":"Vahey","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, , Atlanta, GA 30345,","place":["United States"]},{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-7011","authenticated-orcid":false,"given":"Kristen E","family":"Marshall","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, , Atlanta, GA 30345,","place":["United States"]},{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"McDonald","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, , Atlanta, GA 30345,","place":["United States"]},{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-2299","authenticated-orcid":false,"given":"Rachel","family":"Herlihy","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, CO 80426,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-7361","authenticated-orcid":false,"given":"Helen M","family":"Chun","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1992-7079","authenticated-orcid":false,"given":"Marie E","family":"Killerby","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breanna","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, CO 80426,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5196-4713","authenticated-orcid":false,"given":"Claire M","family":"Midgley","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8128-7714","authenticated-orcid":false,"given":"Nisha B","family":"Alden","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, CO 80426,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8114-6196","authenticated-orcid":false,"given":"Jacqueline E","family":"Tate","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1446-4071","authenticated-orcid":false,"given":"J Erin","family":"Staples","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, Division of Emergency Operations, , Atlanta, GA 30329, and Fort Collins, CO 80521,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colorado Investigation","family":"Team","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, CO 80426,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"issue":"18","key":"2024100815271714000_ref1","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med."},{"issue":"15","key":"2024100815271714000_ref2","doi-asserted-by":"publisher","first-page":"458","DOI":"10.15585\/mmwr.mm6915e3","article-title":"Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 states, March 1-30, 2020","volume":"69","author":"Garg","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"12","key":"2024100815271714000_ref3","doi-asserted-by":"publisher","first-page":"343","DOI":"10.15585\/mmwr.mm6912e2\"&gt;https:\/\/doi.org\/10.15585\/mmwr.mm6912e2","article-title":"Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020","volume":"69","author":"CDC COVID-19 Response Team","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"6","key":"2024100815271714000_ref4","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1016\/j.mayocp.2021.04.008","article-title":"Leveraging the electronic health record to address the COVID-19 pandemic","volume":"96","author":"Satterfield","year":"2021","journal-title":"Mayo Clin Proc."},{"issue":"6","key":"2024100815271714000_ref5","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1007\/s00125-017-4518-6","article-title":"Promises and pitfalls of electronic health record analysis","volume":"61","author":"Farmer","year":"2018","journal-title":"Diabetologia."},{"issue":"10","key":"2024100815271714000_ref6","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1016\/j.clinthera.2021.09.00\\2","article-title":"Electronic health record network research in infectious diseases","volume":"43","author":"Jhaveri","year":"2021","journal-title":"Clin Ther."},{"issue":"10","key":"2024100815271714000_ref7","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s11908-019-0694-5","article-title":"Electronic health record use in public health infectious disease surveillance, USA, 2018-2019","volume":"21","author":"Willis","year":"2019","journal-title":"Curr Infect Dis Rep."},{"issue":"11","key":"2024100815271714000_ref8","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1056\/NEJMp0900665","article-title":"Health care and the American recovery and reinvestment act","volume":"360","author":"Steinbrook","year":"2009","journal-title":"N Engl J Med."},{"issue":"1","key":"2024100815271714000_ref9","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1186\/s12874-021-01416-5","article-title":"A narrative review on the validity of electronic health record-based research in epidemiology","volume":"21","author":"Gianfrancesco","year":"2021","journal-title":"BMC Med Res Methodol."},{"issue":"5","key":"2024100815271714000_ref10","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1016\/j.jbi.2013.06.010","article-title":"Defining and measuring completeness of electronic health records for secondary use","volume":"46","author":"Weiskopf","year":"2013","journal-title":"J Biomed Inform."},{"issue":"3","key":"2024100815271714000_ref11","doi-asserted-by":"publisher","first-page":"e22219","DOI":"10.2196\/22219","article-title":"What every reader should know about studies using electronic health record data but may be afraid to ask","volume":"23","author":"Kohane","year":"2021","journal-title":"J Med Internet Res"},{"key":"2024100815271714000_ref12","doi-asserted-by":"publisher","first-page":"48","DOI":"10.5210\/disco.v6i0.3581","article-title":"Bias associated with mining electronic health records","volume":"6","author":"Hripcsak","year":"2011","journal-title":"J Biomed Discov Collab."},{"issue":"20","key":"2024100815271714000_ref13","doi-asserted-by":"publisher","first-page":"31180","DOI":"10.1016\/S0140-6736(20)31180-6","article-title":"RETRACTED: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis","volume":"S0140\u20136736","author":"Mehra","year":"2020","journal-title":"Lancet."},{"issue":"26","key":"2024100815271714000_ref14","doi-asserted-by":"publisher","first-page":"2582","DOI":"10.1056\/NEJMc2021225","article-title":"Retraction: cardiovascular disease, drug therapy, and mortality in Covid-19","volume":"382","author":"Mehra","year":"2020","journal-title":"N Engl J Med."},{"key":"2024100815271714000_ref15","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1471-2288-14-50","article-title":"Concordance between medical records and interview data in correctional facilities","volume":"14","author":"Bai","year":"2014","journal-title":"BMC Med Res Methodol."},{"issue":"1","key":"2024100815271714000_ref16","doi-asserted-by":"publisher","first-page":"1955493","DOI":"10.1080\/22423982.2021.1955493","article-title":"Discrepancy between electronic medicine list, pharmacy delivery and patient reported medicine intake in Greenland","volume":"80","author":"Kleist","year":"2021","journal-title":"Int J Circumpolar Health."},{"issue":"7","key":"2024100815271714000_ref17","doi-asserted-by":"publisher","first-page":"626","DOI":"10.18553\/jmcp.2008.14.7.626","article-title":"Sources and types of discrepancies between electronic medical records and actual outpatient medication use","volume":"14","author":"Orrico","year":"2008","journal-title":"J Manag Care Pharm."},{"issue":"2","key":"2024100815271714000_ref18","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1007\/BF02982562","article-title":"Factors associated with errors in self-reported height and weight in older adults","volume":"12","author":"Sahyoun","year":"2008","journal-title":"J Nutr Health Aging."},{"issue":"9","key":"2024100815271714000_ref19","doi-asserted-by":"publisher","first-page":"e0256917","DOI":"10.1371\/journal.pone.0256917","article-title":"Risk factors for hospitalization among persons with COVID-19-Colorado","volume":"16","author":"Vahey","year":"2021","journal-title":"PloS One"},{"key":"2024100815271714000_ref20","author":"US Department of Health and Human Services"},{"issue":"2","key":"2024100815271714000_ref21","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform."},{"issue":"1","key":"2024100815271714000_ref22","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics."},{"issue":"2","key":"2024100815271714000_ref23","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.ttbdis.2018.10.010","article-title":"Epidemiology of Lyme disease in Pennsylvania 2006-2014 using electronic health records","volume":"10","author":"Moon","year":"2019","journal-title":"Ticks Tick Borne Dis."},{"key":"2024100815271714000_ref24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1200\/CCI.18.00059","article-title":"Low concordance of patient-reported outcomes with clinical and clinical trial documentation","volume":"2","author":"Fares","year":"2018","journal-title":"JCO Clin Cancer Inform."},{"key":"2024100815271714000_ref25","doi-asserted-by":"publisher","DOI":"10.1177\/21501319231166921","article-title":"Burnout related to electronic health record use in primary care","volume":"14","author":"Budd","year":"2023","journal-title":"J Prim Care Community Health."},{"key":"2024100815271714000_ref26","author":"Centers for Disease Control and Prevention","year":"2020"},{"issue":"8","key":"2024100815271714000_ref27","first-page":"530","article-title":"Agreement between patient-reported symptoms and their documentation in the medical record","volume":"14","author":"Pakhomov","year":"2008","journal-title":"Am J Manag Care."},{"issue":"7","key":"2024100815271714000_ref28","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1038\/s41591-020-0916-2","article-title":"Real-time tracking of self-reported symptoms to predict potential COVID-19","volume":"26","author":"Menni","year":"2020","journal-title":"Nat Med."},{"issue":"2","key":"2024100815271714000_ref29","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3201\/eid2702.203729","article-title":"Symptom profiles and progression in hospitalized and nonhospitalized patients with coronavirus disease, Colorado, USA, 2020","volume":"27","author":"Vahey","year":"2021","journal-title":"Emerg Infect Dis."},{"issue":"3","key":"2024100815271714000_ref30","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.mcna.2017.12.009","article-title":"The electronic health record and the clinical examination","volume":"102","author":"Hedian","year":"2018","journal-title":"Med Clin North Am."},{"issue":"6","key":"2024100815271714000_ref31","doi-asserted-by":"publisher","first-page":"e13313","DOI":"10.2196\/13313","article-title":"Unintended consequences of nationwide electronic health record adoption: challenges and opportunities in the post-meaningful use era","volume":"21","author":"Colicchio","year":"2019","journal-title":"J Med Internet Res"},{"issue":"9","key":"2024100815271714000_ref32","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1016\/j.ajem.2013.06.014","article-title":"Discordance between patient report and chart review of risk factors for antimicrobial resistance in ED patients","volume":"31","author":"Caterino","year":"2013","journal-title":"Am J Emerg Med."},{"issue":"10","key":"2024100815271714000_ref33","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1016\/j.jclinepi.2004.04.005","article-title":"Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure","volume":"57","author":"Okura","year":"2004","journal-title":"J Clin Epidemiol."},{"key":"2024100815271714000_ref34","doi-asserted-by":"publisher","first-page":"170085","DOI":"10.5888\/pcd15.170085","article-title":"Linking data from health surveys and electronic health records: a demonstration project in two Chicago health center clinics","volume":"15","author":"Wagaw","year":"2018","journal-title":"Prev Chronic Dis"},{"issue":"6","key":"2024100815271714000_ref35","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1016\/j.jclinepi.2006.09.003","article-title":"Agreement of self-reported comorbid conditions with medical and physician reports varied by disease among end-stage renal disease patients","volume":"60","author":"Merkin","year":"2007","journal-title":"J Clin Epidemiol."},{"issue":"1","key":"2024100815271714000_ref36","doi-asserted-by":"publisher","first-page":"e130","DOI":"10.1017\/cts.2023.548","article-title":"Electronic health record data quality variability across a multistate clinical research network","volume":"7","author":"Mohamed","year":"2023","journal-title":"J Clin Transl Sci"},{"key":"2024100815271714000_ref37","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/1472-6947-14-51","article-title":"Hidden in plain sight: bias towards sick patients when sampling patients with sufficient electronic health record data for research","volume":"14","author":"Rusanov","year":"2014","journal-title":"BMC Med Inform Decis Mak."},{"issue":"3","key":"2024100815271714000_ref38","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1097\/EDE.0000000000000794","article-title":"Out-of-system care and recording of patient characteristics critical for comparative effectiveness research","volume":"29","author":"Lin","year":"2018","journal-title":"Epidemiology."},{"issue":"1","key":"2024100815271714000_ref39","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1111\/1475-6773.12321","article-title":"Does the relationship of the proxy to the target person affect the concordance between survey reports and medicare claims measures of health services use?","volume":"51","author":"Wehby","year":"2016","journal-title":"Health Serv Res."},{"issue":"9","key":"2024100815271714000_ref40","doi-asserted-by":"publisher","first-page":"e38144","DOI":"10.2196\/38144","article-title":"The impact of electronic health record interoperability on safety and quality of care in high-income countries: systematic review","volume":"24","author":"Li","year":"2022","journal-title":"J Med Internet Res"},{"issue":"7","key":"2024100815271714000_ref41","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1016\/j.clinthera.2020.05.003","article-title":"Hepatic adaptation to therapeutic doses of acetaminophen: an exploratory study in healthy individuals","volume":"42","author":"Maeda","year":"2020","journal-title":"Clin Ther."},{"key":"2024100815271714000_ref42","author":"US Census Bureau","year":"2022"},{"issue":"1","key":"2024100815271714000_ref43","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1197\/jamia.M3390","article-title":"Quantifying clinical narrative redundancy in an electronic health record","volume":"17","author":"Wrenn","year":"2010","journal-title":"J Am Med Inform Assoc."},{"issue":"1","key":"2024100815271714000_ref44","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1186\/s12874-023-01964-y","article-title":"Use of electronic health data to identify patients with moderate-to-severe osteoarthritis of the hip and\/or knee and inadequate response to pain medications","volume":"23","author":"Lu","year":"2023","journal-title":"BMC Med Res Methodol"},{"key":"2024100815271714000_ref45","doi-asserted-by":"publisher","first-page":"1224529","DOI":"10.3389\/frai.2023.1224529","article-title":"Editorial: information extraction for health documents","volume":"6","author":"Mensa","year":"2023","journal-title":"Front Artif Intell."}],"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwae079\/58928291\/kwae079.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/aje\/article-pdf\/193\/10\/1442\/59634674\/kwae079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/aje\/article-pdf\/193\/10\/1442\/59634674\/kwae079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T16:19:24Z","timestamp":1728404364000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/article\/193\/10\/1442\/7679111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,22]]},"references-count":45,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,5,22]]},"published-print":{"date-parts":[[2024,10,7]]}},"URL":"https:\/\/doi.org\/10.1093\/aje\/kwae079","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,5,22]]}}}