Reusing electronic patient data for dental clinical research: a review of current status

Abstract

Objectives: The reuse of electronic patient data collected during clinical care has received increased attention as a way to increase our evidence base. The purpose of this paper was to review studies reusing electronic patient data for dental research.

Data sources: 1527 citations obtained by searching MEDLINE and Embase databases, hand-searching seven dental and informatics journals, and snowball sampling.

Study selection: We included studies reusing electronic patient data for research on dental and craniofacial topics, alone or in combination with medical conditions, medications and outcomes. Studies using administrative or research databases and systematic reviews were excluded. Three reviewers extracted data independently and performed analysis jointly

Results: The 60 studies reviewed covered epidemiological (32 studies), outcomes (16), health services research (10) and other (2) topics; were primarily retrospective (58 studies); varied significantly in sample size (9-153,619 patients) and follow-up period (1-12 years); often drew on other data sources in addition to electronic ones (25); but rarely tapped electronic dental record (EDR) data in private practices (3). Type of research was not associated with data sources used, but research topics/questions were. The most commonly reported advantages of reusing electronic data were being able to study large samples and saving time, while data quality and the inability to capture study-specific data were identified as major limitations.

Conclusions: Dental research reusing electronic patient data is nascent but accelerating. Future EDR design should focus on enhancing data quality, begin to integrate research data collection and implement interoperability with electronic medical records to facilitate oral-systemic investigations.

Clinical significance: Measuring and improving the quality of dental care requires that we begin to reuse electronic patient data collected in practice for clinical research. Practice data can potentially serve as a useful complement to data collected in traditional research studies.

Keywords: AO; CHD; Clinical research; DMF; Dental informatics; Dental records; EDR; EHR; EMR; Electronic health records; HMO; Medical records systems, computerized; NDPBRN; NIDCR; National Dental Practice-based Research Network; National Institute of Dental and Craniofacial Research; ONJ; OSA; PBRN; Review; VA; Veterans Affairs; atypical odontalgia; coronary heart disease; decayed missing and filled teeth; electronic dental records; electronic health records; electronic medical records; health maintenance organization; obstructive sleep apnea; osteonecrosis of the jaw; practice-based research network.