Using electronic health records for population health sciences: a case study to evaluate the associations between changes in left ventricular ejection fraction and the built environment.

摘要: Objective Electronic health record (EHR) data linked with address-based metrics using geographic information systems (GIS) are emerging sources in population studies. This study examined this approach through a case on the associations between changes ejection fraction (EF) and built environment among heart failure (HF) patients. Materials methods We identified 1287 HF patients at least 2 left ventricular EF measurements that minimally 1 year apart. EHR were obtained an academic medical center New York for who visited 2012 2017. Longitudinal clinical was related to transportation, air quality, land use, accessibility by GIS. The primary outcome is increase severity of categories. Statistical analyses performed mixed-effects models, including subgroup analysis initially had normal measurements. Results Previously reported effects from identified. Increased daily nitrogen dioxide concentration associated while controlling known risk factors sex, comorbidities, medication usage. In analysis, significantly decreased distance subway stops increased parks. Conclusions Population studies may drive efficient hypothesis generation enable novel technology-based interventions. availability more precise home locations, frequent collection individual-level social determinants further use