{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:04:58Z","timestamp":1784613898580,"version":"3.55.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Electronic medical records (EMRs) are essential for pharmacoepidemiologic research; however, information on the quality of Canadian hospital EMR data is scarce. We aimed to test data validity in the Epic EMR for key pharmacoepidemiologic themes using QT-prolonging medications and major adverse cardiac events (MACEs) as the research question.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An entity relationship diagram (ERD) was developed to navigate &amp;gt;20,000 tables. Computational data validation (comparison with Epic SlicerDicer and Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) data) and manual data validation (chart review) were applied with iterative adjustments. Percent agreement with 95% confidence intervals was used to estimate data validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ERD demonstrated that 43 tables are needed for key pharmacoepidemiologic research data. A cohort of 70,078 adult inpatients was used for computational validation and 2,281 patient charts for manual validation. Demographics (for example, age, sex, gender, admitting service, and critical care transfers); exposures (medication administrations); many potential confounders (lab results, interacting drugs, and electrocardiograms [EKGs]); and most timestamping (admission, medication administrations, death, lab results, and EKGs) were validated with &amp;gt;95% agreement. Inadequate agreement for MACE (other than death) brought the primary outcome MACE agreement to &amp;lt;90%, requiring patient-level linkage to CIHI-DAD to improve agreement. Comorbidities, including hypertension and heart failure, also required this linkage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A world-leading proprietary EMR after the painstaking development of an ERD and validation of key data fields showed that not all data are of sufficient quality for pharmacoepidemiologic research. Linked human-coded data are required for some diagnoses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1812502","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:34:54Z","timestamp":1784612094000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterization and validation of electronic medical record data for pharmacoepidemiologic research"],"prefix":"10.3389","volume":"17","author":[{"given":"Tyler","family":"Schneider","sequence":"first","affiliation":[{"name":"Clinical Pharmacology Research, Research Institute of St Joe\u2019s Hamilton","place":["Hamilton, ON, Canada"]},{"name":"Department of Pharmacy, Hamilton Health Sciences","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvi","family":"Punjani","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Research, Research Institute of St Joe\u2019s Hamilton","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessyca Matos","family":"Silva","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Research, Research Institute of St Joe\u2019s Hamilton","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact (HEI), McMaster University","place":["Hamilton, ON, Canada"]},{"name":"Department of Anesthesia, McMaster University","place":["Hamilton, ON, Canada"]},{"name":"Department of Pediatrics, McMaster University","place":["Hamilton, ON, Canada"]},{"name":"Biostatistics Unit, Research Institute of St. Joe\u2019s Hamilton","place":["Hamilton, ON, Canada"]},{"name":"Centre for Development of Best Practices in Health (CDBPH), Yaound\u00e9 Central Hospital","place":["Yaound\u00e9, Cameroon"]},{"name":"Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University","place":["Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McMaster University","place":["Hamilton, ON, Canada"]},{"name":"Division of Haematology\/Oncology, McMaster Children\u2019s Hospital","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Research, Research Institute of St Joe\u2019s Hamilton","place":["Hamilton, ON, Canada"]},{"name":"Department of Health Research Methods, Evidence and Impact (HEI), McMaster University","place":["Hamilton, ON, Canada"]},{"name":"Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1742-5573-8-1","article-title":"WINPEPI updated: computer programs for epidemiologists, and their teaching potential","volume":"8","author":"Abramson","year":"2011","journal-title":"Epidemiol. 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