title: The utility of general purpose versus specialty clinical databases for research: warfarin dose estimation from extracted clinical variables.
abstract: There is debate about the utility of clinical data warehouses for research. Using a clinical warfarin dosing algorithm derived from research-quality data, we evaluated the data quality of both a general-purpose database and a coagulation-specific database. We evaluated the functional utility of these repositories by using data extracted from them to predict warfarin dose. We reasoned that high-quality clinical data would predict doses nearly as accurately as research data, while poor-quality clinical data would predict doses less accurately. We evaluated the Mean Absolute Error (MAE) in predicted weekly dose as a metric of data quality. The MAE was comparable between the clinical gold standard (10.1mg/wk) and the specialty database (10.4 mg/wk), but the MAE for the clinical warehouse was 40% greater (14.1mg/wk). Our results indicate that the research utility of clinical data collected in focused clinical settings is greater than that of data collected during general-purpose clinical care.
authors.affiliation: Stanford University, Stanford, CA, USA.
authors.forename: Hersh
authors.initials: H
authors.lastname: Sagreiya
authors.forename: Russ B
authors.initials: RB
authors.lastname: Altman
mesh_terms: D000465:Algorithms; D000925:Anticoagulants / Q000008:administration & dosage*; D035843:Biomedical Research; D001702:Biopharmaceutics / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D054796:Drug Dosage Calculations; D006801:Humans; D008490:Medical Informatics / Q000379:methods*; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014859:Warfarin