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Current use and costs of electronic health records for clinical trial research : a descriptive study

Mc Cord, Kimberly A. and Ewald, Hannah and Ladanie, Aviv and Briel, Matthias and Speich, Benjamin and Bucher, Heiner C. and Hemkens, Lars G. and RCD for RCTs initiative and the Making Randomized Trials More Af, . (2019) Current use and costs of electronic health records for clinical trial research : a descriptive study. CMAJ open, 7 (1). E23-E32.

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Abstract

Electronic health records (EHRs) may support randomized controlled trials (RCTs). We aimed to describe the current use and costs of EHRs in RCTs, with a focus on recruitment and outcome assessment.; This descriptive study was based on a PubMed search of RCTs published since 2000 that evaluated any medical intervention with the use of EHRs. Cost information was obtained from RCT investigators who used EHR infrastructures for recruitment or outcome measurement but did not explore EHR technology itself.; We identified 189 RCTs, most of which (153 [81.0%]) were carried out in North America and were published recently (median year 2012 [interquartile range 2009-2014]). Seventeen RCTs (9.0%) involving a median of 732 (interquartile range 73-2513) patients explored interventions not related to EHRs, including quality improvement, screening programs, and collaborative care and disease management interventions. In these trials, EHRs were used for recruitment (14 [82%]) and outcome measurement (15 [88%]). Overall, in most of the trials (158 [83.6%]), the outcome (including many of the most patient-relevant clinical outcomes, from unscheduled hospital admission to death) was measured with the use of EHRs. The per-patient cost in the 17 EHR-supported trials varied from US$44 to US$2000, and total RCT costs from US$67 750 to US$5 026 000. In the remaining 172 RCTs (91.0%), EHRs were used as a modality of intervention.; Randomized controlled trials are frequently and increasingly conducted with the use of EHRs, but mainly as part of the intervention. In some trials, EHRs were used successfully to support recruitment and outcome assessment. Costs may be reduced once the data infrastructure is established.
Faculties and Departments:03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
10 Zentrale universitäre Einrichtungen > Universitätsbibliothek
UniBasel Contributors:Ladanie, Aviv and Ladanie, Aviv and Ewald, Hannah
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:CMA
ISSN:2291-0026
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:07 Jan 2020 15:37
Deposited On:05 Mar 2019 15:45

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