title: A rigorous algorithm to detect and clean inaccurate adult height records within EHR systems.
abstract: BACKGROUND
  Height is a critical variable for many biomedical analyses because it is an important component of Body Mass Index (BMI). Transforming EHR height measures into meaningful research-ready values is challenging and there is limited information available on methods for "cleaning" these data.
  
  
  OBJECTIVE
  We sought to develop an algorithm to clean adult height data extracted from EHR using only height values and associated ages.
  
  
  RESULTS
  The algorithm we developed is sensitive to normal decreases in adult height associated with aging, is implemented using an open-source software tool and is thus easily modifiable, and is freely available. We checked the performance of our algorithm using data from the Northwestern biobank and a replication sample from the Marshfield Clinic biobank obtained through our participation in the eMERGE consortium. The algorithm identified 1262 erroneous values from a total of 33937 records in the Northwestern sample. Replacing erroneous height values with those identified as correct by the algorithm resulted in meaningful changes in height and BMI records; median change in recorded height after cleaning was 7.6 cm and median change in BMI was 2.9 kg/m(2). Comparison of cleaned EHR height values to observer measured values showed that 94.5% (95% C.I 93.8-% - 95.2%) of cleaned values were within 3.5 cm of observer measured values.
  
  
  CONCLUSIONS
  Our freely available height algorithm cleans EHR height data with only height and age inputs. Use of this algorithm will benefit groups trying to perform research with height and BMI data extracted from EHR.
authors.affiliation: Northwestern University, Center for Genetic Medicine , Chicago, Illinois, United States.
authors.forename: A
authors.initials: A
authors.lastname: Muthalagu
authors.affiliation: Northwestern University, Center for Genetic Medicine , Chicago, Illinois, United States.
authors.forename: J A
authors.initials: JA
authors.lastname: Pacheco
authors.affiliation: Northwestern University, Center for Genetic Medicine , Chicago, Illinois, United States.
authors.forename: S
authors.initials: S
authors.lastname: Aufox
authors.affiliation: Marshfield Clinic Research Foundation , Marshfield, WI.
authors.forename: P L
authors.initials: PL
authors.lastname: Peissig
authors.affiliation: Marshfield Clinic Research Foundation , Marshfield, WI.
authors.forename: J T
authors.initials: JT
authors.lastname: Fuehrer
authors.affiliation: Weis Center for Research, Geisinger Health System , Danville, PA.
authors.forename: G
authors.initials: G
authors.lastname: Tromp
authors.affiliation: Department of Medicine, Northwestern University , Chicago, Illinois, United States.
authors.forename: A N
authors.initials: AN
authors.lastname: Kho
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine , Chicago, Illinois, United States.
authors.forename: L J
authors.initials: LJ
authors.lastname: Rasmussen-Torvik
mesh_terms: D000328:Adult; D000465:Algorithms; D001827:Body Height; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Height; body mass index; dimensional measurement accuracy; electronic health record; electronic medical record; phenotyping
references.citation: J Am Med Inform Assoc. 2013 Jun;20(e1):e147-54
references.pmid: 23531748
references.citation: Obes Rev. 2007 Jul;8(4):307-26
references.pmid: 17578381
references.citation: Sci Transl Med. 2011 Apr 20;3(79):79re1
references.pmid: 21508311
references.citation: Am J Prev Med. 2012 Apr;42(4):342-7
references.pmid: 22424246
references.citation: Osteoporos Int. 2006 Feb;17(2):290-6
references.pmid: 16143833
references.citation: Epidemiol Rev. 1999;21(2):247-60
references.pmid: 10682261
references.citation: J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):516-22
references.pmid: 16881996
references.citation: Nat Genet. 2008 May;40(5):609-15
references.pmid: 18391951
references.citation: J Rehabil Res Dev. 2010;47(8):739-50
references.pmid: 21141302
references.citation: Arch Dis Child. 1992 Nov;67(11):1357-62
references.pmid: 1471886
references.citation: BMC Public Health. 2009 Nov 19;9:421
references.pmid: 19922675
references.citation: J Clin Epidemiol. 2008 Mar;61(3):261-267
references.pmid: 18226749
references.citation: J Am Med Inform Assoc. 2012 Mar-Apr;19(2):212-8
references.pmid: 22101970
references.citation: BMC Med Res Methodol. 2013 Mar 13;13:38
references.pmid: 23510189