Considering the Totality of Evidence: Integrating EHR and Primary Data Collection to Improve Medical Decision Making

Music City Center 

Randomized clinical trials (RCTs) are considered the gold standard for evaluating treatment efficacy but suffer from limitations. Vulnerable populations are under-represented in RCTs, raising concerns about equity and the external validity of results. Additionally, clinical trials may not reflect care and outcomes as they are experienced in routine practice and can be slow to provide timely evidence in the face of rapidly evolving public health crises. Electronic health records (EHR) have the potential to address many of these concerns. However, limitations of EHR necessitate careful attention to study design and statistical methods. Informed by my experience collaborating with oncologists to advance understanding of cancer treatment utilization and effectiveness, I will discuss the potential, and methodological challenges, of using EHR data to supplement RCTs by providing both more timely and generalizable evidence on treatment efficacy.

electronic health records

RCT

missing data

measurement error