title: Are All Vaccines Created Equal? Using Electronic Health Records to Discover Vaccines Associated With Clinician-Coded Adverse Events.
abstract: Adverse drug events (ADEs) are responsible for unnecessary patient deaths making them a major public health issue. Literature estimates 1% of ADEs recorded in Electronic Health Records (EHRs) are reported to federal databases making EHRs a vital source of ADE-related information. Using Columbia University Medical Center (CUMC)'s EHRs, we developed an algorithm to mine for vaccine-related ADEs occurring within 3 months of vaccination. In phase one, we measured the association between vaccinated patients with an ADE (cases) against those vaccinated without an ADE. To adjust for healthcare-process effects, phase two compared cases against those who returned to CUMC within 3 months without an ADE. We report 7 results passing multiplicity correction after demographic confounder adjustment. We observed an association, having some literature support, between swine flu vaccination and ADEs (H1N1v-like, OR=9.469, p<0.001; H1N1/H3N2, OR=3.207, p<0.001). Our algorithm could inform clinicians of the risks/benefits of vaccinations towards improving clinical care.
authors: Department of Biomedical Informatics, Columbia University ; Observational Health Data Sciences and Informatics, Columbia University.
authors: Mary Regina
authors: MR
authors: Boland
authors: Department of Biomedical Informatics, Columbia University ; Department of Medicine, Columbia University ; Department of Systems Biology, Columbia University ; Observational Health Data Sciences and Informatics, Columbia University.
authors: Nicholas P
authors: NP
authors: Tatonetti