Challenges Associated With Using Large Data Sets for Quality Assessment and Research in Clinical Settings

Abstract

The rapidly expanding use of electronic records in health-care settings is generating unprecedented quantities of data available for clinical, epidemiological, and cost-effectiveness research. Several challenges are associated with using these data for clinical research, including issues surrounding access and information security, poor data quality, inconsistency of data within and across institutions, and a paucity of staff with expertise to manage and manipulate large clinical data sets. In this article, we describe our experience with assembling a data-mart and conducting clinical research using electronic data from four facilities within a single hospital network in New York City. We culled data from several electronic sources, including the institution’s admission-discharge-transfer system, cost accounting system, electronic health record, clinical data warehouse, and departmental records. The final data-mart contained information for more than 760,000 discharges occurring from 2006 through 2012. Using categories identified by the National Institutes of Health Big Data to Knowledge initiative as a framework, we outlined challenges encountered during the development and use of a domain-specific data-mart and recommend approaches to overcome these challenges.

Impact of nursing diagnoses on patient and organisational outcomes: a systematic literature review

“…Nevertheless, the value of these databases can be reduced by poor data quality, inconsistency of data within and across institutions and difficulties in determining causal relationships among factors (Cohen et al . ).…”

“…Almost half of these studies were based on an analysis of existing databases; the opportunity to analyse vast amounts of data, including nursing elements, undoubtedly provides a great opportunity. Nevertheless, the value of these databases can be reduced by poor data quality, inconsistency of data within and across institutions and difficulties in determining causal relationships among factors (Cohen et al 2015).…”

Informatics competencies essential to decision making in nursing management

“…Management of individualized care and care plans, as well as data generated by these reports, has been employed as a strategy for the development of clinical studies that begin with the electronic data from the systems used in hospitals, generating indicators and assessments (21) .…”

Strategies for overcoming language barriers in research

“…studies-Whilst there is a huge attraction to use big data to analyse health related issues tied to patient language preference, bigger does not always mean better (Cohen et al, 2015;O'Halloran, Tan, Pham, Bateman, & Vande Moere, 2018). In addition to the many known problems that come with working with large datasets in health care, isolating language barrier related relationships and effects have their own challenges in observational studies.…”