Research and Reporting Considerations for Observational Studies Using Electronic Health Record Data

Ann Intern Med. 2020 Jun 2;172(11 Suppl):S79-S84. doi: 10.7326/M19-0873.


Electronic health records (EHRs) are an increasingly important source of real-world health care data for observational research. Analyses of data collected for purposes other than research require careful consideration of data quality as well as the general research and reporting principles relevant to observational studies. The core principles for observational research in general also apply to observational research using EHR data, and these are well addressed in prior literature and guidelines. This article provides additional recommendations for EHR-based research. Considerations unique to EHR-based studies include assessment of the accuracy of computer-executable cohort definitions that can incorporate unstructured data from clinical notes and management of data challenges, such as irregular sampling, missingness, and variation across time and place. Principled application of existing research and reporting guidelines alongside these additional considerations will improve the quality of EHR-based observational studies.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Data Collection
  • Electronic Health Records / standards*
  • Humans
  • Observational Studies as Topic / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*