Journal of General Internal Medicine

, Volume 29, Issue 7, pp 976–978 | Cite as

Prospective EHR-Based Clinical Trials: The Challenge of Missing Data

  • Hadi Kharrazi
  • Chenguang Wang
  • Daniel Scharfstein

This discussion focuses on the challenges of using prospectively collected electronic health record (EHR) data as outcomes in clinical trials, with a particular emphasis on the issue of missing data. Our discussion is motivated by the article in this issue: ‘Translating the Hemoglobin A1C with More Easily Understood Feedback: A Randomized Controlled Trial’ by Gopalan et al.1 In the spirit of open science, the authors generously shared their study protocol, statistical analysis plan and analysis data set. Using their data set, we conducted analyses to help emphasize important statistical issues. This editorial should not be considered a criticism of their paper; rather, their study is used as a reference to expand on the challenges of missing data in EHRs and to provide suggestions for future studies.


The HITECH2act has empowered and incentivized healthcare providers to adopt EHRs. As a result, there has been a dramatic rise in EHR...


American Diabetes Association Electronic Health Record Health Information Exchange Electronic Health Record System Electronic Health Record Data 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  • Hadi Kharrazi
    • 1
  • Chenguang Wang
    • 2
  • Daniel Scharfstein
    • 3
  1. 1.Department of Health Policy and Management, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  2. 2.Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins UniversityBaltimoreUSA
  3. 3.Department of Biostatistics, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA

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