Informative Missingness: What can we learn from patterns in missing laboratory data in the electronic health record?
Informative Missingness: What can we learn from patterns in missing laboratory data in the electronic health record?
Abstract BackgroundIn electronic health records, patterns of missing laboratory test results could capture patients’ course of disease as well as reflect clinician’s concerns or worries for possible conditions. These patterns are often understudied and overlooked. This study aims to characterize the patterns of missingness among laboratory data collected across 15 healthcare system sites in three countries for COVID-19 inpatients. MethodsWe collected and analyzed demographic, diagnosis, and laboratory data for 69,939 patients with positive COVID-19 PCR tests across three countries from 1 January 2020 through 30 September 2021. We analyzed missing laboratory measurements across sites, missingness stratification by demographic variables, temporal trends of missingness, correlations between labs based on missingness indicators over time, and clustering of groups of labs based on their missingness/ordering pattern. ResultsWith these analyses, we identified mapping issues faced in seven out of 15 sites. We also identified nuances in data collection and variable definition for the various sites. Temporal trend analyses may support the use of laboratory test result missingness patterns in identifying severe COVID-19 patients. Lastly, using missingness patterns, we determined relationships between various labs that reflect clinical behaviors. ConclusionThis work elucidates how missing data patterns in EHRs can be leveraged to identify quality control issues and relationships between laboratory measurements. Missing data patterns will allow sites to attain better quality data for subsequent analyses and help researchers identify which sites are better poised to study particular questions. Our results could also provide insight into some of the biological relationships between labs in EHR data for COVID-19 patients.
Strasser Zachary H.、Samayamuthu Malarkodi Jebathilagam、Moal Bertrand、Will Loh He Hooi、Bonzel Clara-Lea、Holmes John H.、Wang Xuan、The Consortium for Clinical Characterization of COVID-19 by EHR (4CE) (Collaborative Group/Consortium)、Mowery Danielle L、Omenn Gilbert S.、Patel Lav P.、Hutch Meghan R.、Le Trang T.、Yuan William、Aronow Bruce J、Brat Gabriel. A.、Hong Chuan、Cava William G. La、Murphy Shawn N.、Hgiam Kee Yuan、Getzen Emily J.、Hanauer David A.、Cai Tianxi、Xia Zongqi、Tan Amelia L.M.、Visweswaran Shyam、Chiudinelli Lorenzo、Das Priam、Dagliati Arianna、Tan Byorn W.L.、Guti¨|rrez-Sacrist¨￠n Alba、Avilllach Paul、Luo Yuan、Long Qi、Weber Griffin M、Hossein Abad Zahra Shakeri、Verdy Bertrand、Shriver Emily R.、Morris Michele、Zhang Harrison G.
Massachusetts General HospitalUniversity of PittsburghBordeaux University HospitalNational University Health SystemsHarvard Medical SchoolUniversity of Pennsylvania Perelman School of MedicineHarvard Medical SchoolUniversity of Pennsylvania Perelman School of MedicineUniversity of MichiganUniversity Of Kansas Medical CenterNorthwestern UniversityUniversity of Pennsylvania Perelman School of MedicineHarvard Medical SchoolCincinnati Children?ˉs Hospital Medical Center, University of CincinnatiHarvard Medical SchoolHarvard Medical School||Duke UniversityHarvard Medical School||Boston Children?ˉs HospitalMassachusetts General HospitalNational University Health SystemsUniversity of Pennsylvania Perelman School of MedicineUniversity of MichiganHarvard Medical SchoolUniversity of PittsburghHarvard Medical SchoolUniversity of PittsburghASST Papa Giovanni XXIIIHarvard Medical SchoolUniversity of PaviaNational University Health SystemsHarvard Medical SchoolHarvard Medical SchoolNorthwestern UniversityUniversity of Pennsylvania Perelman School of MedicineHarvard Medical SchoolHarvard Medical SchoolBordeaux University HospitalUniversity of Pennsylvania Health SystemUniversity of PittsburghHarvard Medical School
医学研究方法医药卫生理论
Strasser Zachary H.,Samayamuthu Malarkodi Jebathilagam,Moal Bertrand,Will Loh He Hooi,Bonzel Clara-Lea,Holmes John H.,Wang Xuan,The Consortium for Clinical Characterization of COVID-19 by EHR (4CE) (Collaborative Group/Consortium),Mowery Danielle L,Omenn Gilbert S.,Patel Lav P.,Hutch Meghan R.,Le Trang T.,Yuan William,Aronow Bruce J,Brat Gabriel. A.,Hong Chuan,Cava William G. La,Murphy Shawn N.,Hgiam Kee Yuan,Getzen Emily J.,Hanauer David A.,Cai Tianxi,Xia Zongqi,Tan Amelia L.M.,Visweswaran Shyam,Chiudinelli Lorenzo,Das Priam,Dagliati Arianna,Tan Byorn W.L.,Guti¨|rrez-Sacrist¨￠n Alba,Avilllach Paul,Luo Yuan,Long Qi,Weber Griffin M,Hossein Abad Zahra Shakeri,Verdy Bertrand,Shriver Emily R.,Morris Michele,Zhang Harrison G..Informative Missingness: What can we learn from patterns in missing laboratory data in the electronic health record?[EB/OL].(2025-03-28)[2025-05-05].https://www.medrxiv.org/content/10.1101/2022.05.08.22274724.点此复制
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