title: Practice databases and their uses in clinical research.
abstract: A few large clinical information databases have been established within larger medical information systems. Although they are smaller than claims databases, these clinical databases offer several advantages: accurate and timely data, rich clinical detail, and continuous parameters (for example, vital signs and laboratory results). However, the nature of the data vary considerably, which affects the kinds of secondary analyses that can be performed. These databases have been used to investigate clinical epidemiology, risk assessment, post-marketing surveillance of drugs, practice variation, resource use, quality assurance, and decision analysis. In addition, practice databases can be used to identify subjects for prospective studies. Further methodologic developments are necessary to deal with the prevalent problems of missing data and various forms of bias if such databases are to grow and contribute valuable clinical information.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Richard L. Roudebush Veterans Administration Hospital, Indianapolis.
authors.forename: W M
authors.initials: WM
authors.lastname: Tierney
authors.forename: C J
authors.initials: CJ
authors.lastname: McDonald
mesh_terms: D015510:Clinical Medicine / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000592:standards*; D003661:Decision Support Techniques; D004812:Epidemiologic Methods; D005544:Forecasting; D006302:Health Services Research / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011358:Product Surveillance, Postmarketing; D011785:Quality Assurance, Health Care; D014481:United States