8:10 am – 8:11 am
Introduction of the Young Investigator Award
Graham E. Quinn, MD
8:11 am – 8:19 am Young Investigator Award Paper
“Big Data on a Small Scale for Pediatric Ophthalmology Research”
Gil Binenbaum, MD, MSCE
8:19 am – 8:20 am
Graham E. Quinn, MD
Big Data on a Small Scale for Pediatric Ophthalmology Research
Gil Binenbaum, MD, MSCE;
The Children’s Hospital Of Philadelphia
Introduction: Electronic medical records (EMR) present an opportunity to answer research questions faster, with much larger amounts of data. This study identified techniques for leveraging EMR to do pediatric ophthalmology research.
Methods: Methodological analysis of multiple retrospective, single-center studies that used EMR data as a primary data source.
Results: EMR enabled rapid identification of subjects when inclusion criteria were defined with consistently used billing codes and clinical variables readily accessible in the EMR. Large datasets were rapidly produced, but varying amounts of manual data collection, interpretation, and coding into analyzable, number-based variables were required. How much “augmentation” was necessary depended upon the study question, how clinicians recorded findings, and how data were stored in the EMR. Examples ranged from extensive (strabismus data), to minimal (uncommon retinal findings), to no (refractive data) extra, manual work. Overcoming variability in strabismus documentation was particularly laborious. Proactive steps were identified that could be taken by clinicians to facilitate EMR research, including entering findings consistently as numbers or codes, using discrete rather than free-text fields, and applying diagnostic codes in a disciplined and thorough manner.
Discussion: Tradeoffs were made between increasing both study efficiency and sample size and disregarding inaccuracies in the EMR. The significance of such limitations depended primarily upon the study question.
Conclusion: Development, adoption, and consistent use of standardized nomenclature and organization of clinical data in the EMR by clinicians in their daily practice facilitate rapid access to large amounts of data for quality improvement and research purposes.
Binenbaum G, et al. Evaluation of Temporal Association between Vaccinations and Retinal Hemorrhage. JAMA Ophthalmology, 133(11): 1261-5, 2015.
Geloneck M, et al. Ocular complications in children with diabetes mellitus. Ophthalmology, 122(12): 2457-64, 2015.
Dawson L, et al. Pediatric Ophthalmologist Glasses Prescribing Patterns. 2014 Annual Meeting of the American Academy of Ophthalmology, Chicago, IL. October 2014.