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Electronic Health Records (EHRs) are typically stored as time-stamped encounter records. Observing temporal relationship between medical records is an integral part of interpreting the information. Hence, statistical analysis of EHRs requires that clinically informed time-interdependent analysis variables (TIAV) be created. Often, formulation and creation of these variables are iterative and requiring custom codes. We describe a technique of using sequences of time-referenced entities as the building blocks for TIAVs. These sequences represent different aspects of patients medical history in a contiguous fashion. To illustrate the principles and applications of the method, we provide examples using Veterans Health Administrations research databases. In the first example, sequences representing medication exposure were used to assess patient selection criteria for a treatment comparative effectiveness study. In the second example, sequences of Charlson Comorbidity conditions and clinical settings of inpatient or outpatient were used to create variables with which data anomalies and trends were revealed. The third example demonstrated the creation of an analysis variable derived from the temporal dependency of medication exposure and comorbidity. Complex time-interdependent analysis variables can be created from the sequences with simple, reusable codes, hence enable unscripted or automation of TIAV creation.
Large scale electronic health records (EHRs) present an opportunity to quickly identify suitable individuals in order to directly invite them to participate in an observational study. EHRs can contain data from millions of individuals, raising the qu
If Electronic Health Records contain a large amount of information about the patients condition and response to treatment, which can potentially revolutionize the clinical practice, such information is seldom considered due to the complexity of its e
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Identifying patients who will be discharged within 24 hours can improve hospital resource management and quality of care. We studied this problem using eight years of Electronic Health Records (EHR) data from Stanford Hospital. We fit models to predi
Recurrent Neural Networks (RNNs) are often used for sequential modeling of adverse outcomes in electronic health records (EHRs) due to their ability to encode past clinical states. These deep, recurrent architectures have displayed increased performa