Biostatistics Seminar speaker, Rebecca Hubbard, PhD, Associate Professor Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, will present, “Using Electronic Health Records to Advance Research on the Cancer Care Continuum”.
The cancer care continuum describes the sequence of events in healthcare delivery related to cancer, beginning with screening and progressing through diagnosis, treatment, and survivorship. Many points in this continuum are best studied with observational data, and data from electronic health records (EHR) are well-suited to this purpose because they reach an enormous population and allow us to characterize cancer care in community practice. Despite this potential, many aspects of EHR data pose a challenge to valid inference including confounding by indication, misclassification of exposures and outcomes, missing data, and informative observation schemes. In this talk, I will present an overview of the opportunities and challenges in studying the cancer care continuum using EHR data. I will present examples of substantive studies of cancer care that motivated methodological investigations to overcome limitations of EHR data. For each example, I will present simulation studies illustrating the potential for erroneous conclusions arising from naïve analysis and introduce methodology to address these challenges. Finally, I will conclude with a discussion of areas where future methodological development is needed.