The utility of EMR address histories for assessing neighborhood exposures.
Electronic medical records (EMRs) include residential address histories, which may alleviate exposure misclassification caused by exclusion of patient spatiotemporal location. EMR data are increasingly available but rarely leveraged as a measure of cumulative environmental exposure, in part due to limited understanding of the validity of EMR-derived address histories.



We compared EMR address histories to self-reported histories among 100 patients of a safety-net health care system completing a telephone survey. We assessed agreement and compared seven neighborhood-level environmental exposures as assessed using both data sources.



While 17.1% of respondents did not live at the most recent EMR-derived address during the survey, nearly all (98%) lived there at some point. For respondents with more than one EMR-derived address (N = 64), 87.5% had once lived at the previous EMR address. Of these, 30.4% lived at 1 or more additional residences between the two most recent EMR address. For all measures, neighborhood-level environmental exposures did not differ when using EMR-derived versus self-report addresses.



More recent EMR-derived addresses are more accurate, and differences compared to self-reported addresses in neighborhood-level exposures are negligible. EMR-derived address histories are incomplete and likely suffer from collection bias; future research should further assess their validity and reliability.
Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas. Electronic address: amy.speer@utsouthwestern.edu.
Amy E
AE
Hughes
Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas; Harold C. Simmons Comprehensive Cancer Center, Dallas, TX.
Sandi L
SL
Pruitt
D000397:Air Pollution / Q000009:adverse effects / Q000706:statistics & numerical data*; D015982:Bias; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D011157:Population Dynamics; D015203:Reproducibility of Results; D012111:Residence Characteristics; D057566:Self Report / Q000706:statistics & numerical data*; D014481:United States
Electronic medical record; Geographic information systems; Neighborhoods; Residential mobility
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