Current Epidemiology Reports

, Volume 5, Issue 4, pp 343–356 | Cite as

Measurement Error and Misclassification in Electronic Medical Records: Methods to Mitigate Bias

  • Jessica C. Young
  • Mitchell M. Conover
  • Michele Jonsson FunkEmail author
Pharmacoepidemiology (S Toh, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pharmacoepidemiology


Purpose of Review

We sought to (1) examine common sources of measurement error in research using data from electronic medical records (EMR), (2) discuss methods to assess the extent and type of measurement error, and (3) describe recent developments in methods to address this source of bias.

Recent Findings

We identified eight sources of measurement error frequently encountered in EMR studies, the most prominent being that EMR data usually reflect only the health services and medications delivered within the specific health facility/system contributing to the EMR data. Methods for assessing measurement error in EMR data usually require gold standard or validation data, which may be possible using data linkage. Recent methodological developments to address the impact of measurement error in EMR analyses were particularly rich in the multiple imputation literature.


Presently, sources of measurement error impacting EMR studies are still being elucidated, as are methods for assessing and addressing them. Given the magnitude of measurement error that has been reported, investigators are urged to carefully evaluate and rigorously address this potential source of bias in studies based in EMR data.


Electronic medical records Measurement error Misclassification Multiple imputation for measurement error Pharmacoepidemiology Comparative effectiveness Real world evidence 


Funding information

Dr. Jonsson Funk, Dr. Conover, and Ms. Young report grant support from the NIH National Institute on Aging (R01 AG056479), NIH National Heart Lung and Blood Institute (R01 HL118255), and NIH National Center for Advancing Translational Sciences (UL1 TR001111).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Jessica C. Young
    • 1
  • Mitchell M. Conover
    • 1
  • Michele Jonsson Funk
    • 1
    Email author
  1. 1.Department of Epidemiology, UNC Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA

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