title: A pragmatic method for electronic medical record-based observational studies: developing an electronic medical records retrieval system for clinical research.
abstract: OBJECTIVE
  The use of electronic medical record (EMR) data is necessary to improve clinical research efficiency. However, it is not easy to identify patients who meet research eligibility criteria and collect the necessary information from EMRs because the data collection process must integrate various techniques, including the development of a data warehouse and translation of eligibility criteria into computable criteria. This research aimed to demonstrate an electronic medical records retrieval system (ERS) and an example of a hospital-based cohort study that identified both patients and exposure with an ERS. We also evaluated the feasibility and usefulness of the method.
  
  
  METHODS
  The system was developed and evaluated.
  
  
  METHODS
  In total, 800 000 cases of clinical information stored in EMRs at our hospital were used.
  
  
  METHODS
  The feasibility and usefulness of the ERS, the method to convert text from eligible criteria to computable criteria, and a confirmation method to increase research data accuracy.
  
  
  RESULTS
  To comprehensively and efficiently collect information from patients participating in clinical research, we developed an ERS. To create the ERS database, we designed a multidimensional data model optimised for patient identification. We also devised practical methods to translate narrative eligibility criteria into computable parameters. We applied the system to an actual hospital-based cohort study performed at our hospital and converted the test results into computable criteria. Based on this information, we identified eligible patients and extracted data necessary for confirmation by our investigators and for statistical analyses with our ERS.
  
  
  CONCLUSIONS
  We propose a pragmatic methodology to identify patients from EMRs who meet clinical research eligibility criteria. Our ERS allowed for the efficient collection of information on the eligibility of a given patient, reduced the labour required from the investigators and improved the reliability of the results.
authors.affiliation: Department of Clinical Trial Design and Management, Translational Research Centre, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Eriko
authors.initials: E
authors.lastname: Sumi
authors.forename: Toru
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Keita
authors.initials: K
authors.lastname: Asai
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Bessho
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yokode
authors.forename: Masanori
authors.initials: M
authors.lastname: Fukushima