@inproceedings{c6f32237e63a4c2bbca1bac81a3951cb,
title = "Secondary Use of EHR: Interpreting Clinician Inter-Rater Reliability Through Qualitative Assessment",
abstract = "In a retrospective secondary-use EHR study identifying a cohort of Non-Valvular Atrial Fibrillation (NVAF) patients, chart abstraction was done by two sets of clinicians to create a gold standard for risk measures CHA2DS2-VASc and HAS-BLED. Inter-rater reliability between each set of clinicians for NVAF and the outcomes of interest were variable, ranging from extremely low agreement to high agreement. To assess the chart abstraction process, a focus group and a survey was conducted. Survey findings revealed patterns of difficulty in assessing certain items dealing with temporality and social data. The focus group raised issues on the quality and completeness of EHR data, including missing encounters, truncated notes, and low granularity. It also raised the issue of the usability of the data system, the Clinical Data Viewer, which did not mirror a live EHR and made it difficult to record outcomes. Finally, the focus group found it was difficult to infer certain outcomes, like severity, from the provided data. These factors produced differences in clinician rated outcomes.",
keywords = "electronic health record, human factors, Medical chart review, qualitative research",
author = "Sarah Mullin and Edwin Anand and Shyamashree Sinha and Buer Song and Jane Zhao and Elkin, \{Peter L.\}",
note = "Publisher Copyright: {\textcopyright} 2017 The authors and IOS Press.; 2017 International Conference on Context Sensitive Health Informatics: Human and Socio-Technical Approaches, CSHI 2017 ; Conference date: 01-08-2017",
year = "2017",
doi = "10.3233/978-1-61499-794-8-165",
language = "English",
series = "Studies in Health Technology and Informatics",
publisher = "IOS Press BV",
pages = "165--172",
editor = "Christian Nohr and Kuziemsky, \{Craig E.\} and Wong, \{Zoie Shui-Yee\}",
booktitle = "Context Sensitive Health Informatics",
address = "Netherlands",
}