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Annals of epidemiology v.27 no.1, 2017년, pp.20 - 26  

The utility of EMR address histories for assessing neighborhood exposures

Hughes, A.E. ; Pruitt, S.L. ;
  • 초록  

    Purpose: 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. Methods: 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. Results: 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. Conclusions: 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.


  • 주제어

    Residential mobility .   Electronic medical record .   Neighborhoods .   Geographic information systems.  

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