Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies
Background Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care. Objectives To characterise breastfeeding information recorded in structured fields in EHR during...
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| Veröffentlicht in: | Paediatric and perinatal epidemiology 2024-08, Vol.38 (6), p.505-514 |
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| creator | Mohamed, Hibo H. Ehresmann, Kirsten Seburg, Elisabeth M. Vazquez‐Benitez, Gabriela Demerath, Ellen W. Fields, David A. Vesco, Kimberly K. Kharbanda, Elyse O. Palmsten, Kristin |
| description | Background
Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care.
Objectives
To characterise breastfeeding information recorded in structured fields in EHR during infant and postpartum health care visits, and to assess the validity of lactation status based on EHR data versus maternal report at research study visits.
Methods
We assessed breastfeeding information recorded in structured fields in EHR from one health system for a subset of 211 patients who were also enrolled in a study on breast milk composition between 2014 and 2017 that required participants to exclusively breastfeed their infants until at least 1 month of age. We assessed the frequency of breastfeeding information in EHR during the first 12 months of age and compared lactation status based on EHR with maternal report at 1 and 6‐month study visits (reference standard).
Results
The median number of breastfeeding records in the EHR per infant was six (interquartile range 3) with most observations clustering in the first few weeks of life and around well‐infant visits. At the 6‐month study visit, 93.8% of participants were breastfeeding and 80.1% were exclusively breastfeeding according to maternal report. Sensitivity of EHR data for identifying ever breastfeeding was at or near 100%, and sensitivity for identifying ever exclusive breastfeeding was 98.0% (95% CI: 95.0%, 99.2%). Sensitivities were 97.3% (95% CI: 93.9%, 98.9%) for identifying any breastfeeding and 94.4% (95% CI: 89.7%, 97.0%) for exclusive breastfeeding, and positive predictive values were 99.5% (95% CI: 97.0%, 99.9%) for any breastfeeding and 95.0% (95% CI: 90.4%, 97.4%) for exclusive breastfeeding.
Conclusions
Breastfeeding information in structured EHR fields have the potential to accurately classify lactation status. The validity of these data should be assessed in populations with a lower breastfeeding prevalence. |
| doi_str_mv | 10.1111/ppe.13051 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2967060021</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3097932732</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3131-a04eb324516f886c5e596caf20e214a359386e90e8c35f6d1def496f471731d23</originalsourceid><addsrcrecordid>eNp1kc9OHSEUh0lTU29tF32BhqQbuxjlz8AMy-ZGWxMTXeiaIBx6McwwhRkbH6LvLDrWhYlsDifnOx8kP4S-UHJE6zmeJjiinAj6Dm0ol6LhhMr3aEOYVI0gjO2jj6XcEkKkUOwD2ud9q1rO5Qb92-5MNnaGHIqZQxqxGR2-MzG4tU0exzpfmzD6lIf17nMacJnzYuclg8MQwc45jcHiHZg473AGm7IruO7gpUDdxlN9bTA2wRQcDCHF9DtYE6tncQHKJ7TnTSzw-bkeoOvTk6vtr-b84ufZ9sd5YznltDGkhRvOWkGl73tpBQglrfGMAKOt4ULxXoIi0FsuvHTUgW-V9G1HO04d4wfocPVOOf1ZoMx6CMVCjGaEtBTNlOyIJITRin57hd6mJY_1d5oT1SnOOv4o_L5SNqdSMng95TCYfK8p0Y8Z6ZqRfsqosl-fjcvNAO6F_B9KBY5X4G-IcP-2SV9enqzKB3tina4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3097932732</pqid></control><display><type>article</type><title>Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Mohamed, Hibo H. ; Ehresmann, Kirsten ; Seburg, Elisabeth M. ; Vazquez‐Benitez, Gabriela ; Demerath, Ellen W. ; Fields, David A. ; Vesco, Kimberly K. ; Kharbanda, Elyse O. ; Palmsten, Kristin</creator><creatorcontrib>Mohamed, Hibo H. ; Ehresmann, Kirsten ; Seburg, Elisabeth M. ; Vazquez‐Benitez, Gabriela ; Demerath, Ellen W. ; Fields, David A. ; Vesco, Kimberly K. ; Kharbanda, Elyse O. ; Palmsten, Kristin</creatorcontrib><description>Background
Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care.
Objectives
To characterise breastfeeding information recorded in structured fields in EHR during infant and postpartum health care visits, and to assess the validity of lactation status based on EHR data versus maternal report at research study visits.
Methods
We assessed breastfeeding information recorded in structured fields in EHR from one health system for a subset of 211 patients who were also enrolled in a study on breast milk composition between 2014 and 2017 that required participants to exclusively breastfeed their infants until at least 1 month of age. We assessed the frequency of breastfeeding information in EHR during the first 12 months of age and compared lactation status based on EHR with maternal report at 1 and 6‐month study visits (reference standard).
Results
The median number of breastfeeding records in the EHR per infant was six (interquartile range 3) with most observations clustering in the first few weeks of life and around well‐infant visits. At the 6‐month study visit, 93.8% of participants were breastfeeding and 80.1% were exclusively breastfeeding according to maternal report. Sensitivity of EHR data for identifying ever breastfeeding was at or near 100%, and sensitivity for identifying ever exclusive breastfeeding was 98.0% (95% CI: 95.0%, 99.2%). Sensitivities were 97.3% (95% CI: 93.9%, 98.9%) for identifying any breastfeeding and 94.4% (95% CI: 89.7%, 97.0%) for exclusive breastfeeding, and positive predictive values were 99.5% (95% CI: 97.0%, 99.9%) for any breastfeeding and 95.0% (95% CI: 90.4%, 97.4%) for exclusive breastfeeding.
Conclusions
Breastfeeding information in structured EHR fields have the potential to accurately classify lactation status. The validity of these data should be assessed in populations with a lower breastfeeding prevalence.</description><identifier>ISSN: 0269-5022</identifier><identifier>ISSN: 1365-3016</identifier><identifier>EISSN: 1365-3016</identifier><identifier>DOI: 10.1111/ppe.13051</identifier><identifier>PMID: 38494336</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Babies ; Breast feeding ; Breast Feeding - statistics & numerical data ; Breast milk ; breastfeeding ; Breastfeeding & lactation ; Electronic health records ; Electronic Health Records - statistics & numerical data ; Electronic medical records ; Epidemiology ; Female ; Health informatics ; Humans ; Infant ; Infant, Newborn ; Infants ; Lactation ; Lactation - physiology ; Maternal & child health ; Milk, Human - chemistry ; Pediatrics ; pharmacoepidemiology ; Pharmacoepidemiology - methods ; Postpartum period ; Reproducibility of Results ; Sensitivity analysis ; validation study</subject><ispartof>Paediatric and perinatal epidemiology, 2024-08, Vol.38 (6), p.505-514</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3131-a04eb324516f886c5e596caf20e214a359386e90e8c35f6d1def496f471731d23</cites><orcidid>0000-0002-0134-6228</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fppe.13051$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fppe.13051$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38494336$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohamed, Hibo H.</creatorcontrib><creatorcontrib>Ehresmann, Kirsten</creatorcontrib><creatorcontrib>Seburg, Elisabeth M.</creatorcontrib><creatorcontrib>Vazquez‐Benitez, Gabriela</creatorcontrib><creatorcontrib>Demerath, Ellen W.</creatorcontrib><creatorcontrib>Fields, David A.</creatorcontrib><creatorcontrib>Vesco, Kimberly K.</creatorcontrib><creatorcontrib>Kharbanda, Elyse O.</creatorcontrib><creatorcontrib>Palmsten, Kristin</creatorcontrib><title>Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies</title><title>Paediatric and perinatal epidemiology</title><addtitle>Paediatr Perinat Epidemiol</addtitle><description>Background
Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care.
Objectives
To characterise breastfeeding information recorded in structured fields in EHR during infant and postpartum health care visits, and to assess the validity of lactation status based on EHR data versus maternal report at research study visits.
Methods
We assessed breastfeeding information recorded in structured fields in EHR from one health system for a subset of 211 patients who were also enrolled in a study on breast milk composition between 2014 and 2017 that required participants to exclusively breastfeed their infants until at least 1 month of age. We assessed the frequency of breastfeeding information in EHR during the first 12 months of age and compared lactation status based on EHR with maternal report at 1 and 6‐month study visits (reference standard).
Results
The median number of breastfeeding records in the EHR per infant was six (interquartile range 3) with most observations clustering in the first few weeks of life and around well‐infant visits. At the 6‐month study visit, 93.8% of participants were breastfeeding and 80.1% were exclusively breastfeeding according to maternal report. Sensitivity of EHR data for identifying ever breastfeeding was at or near 100%, and sensitivity for identifying ever exclusive breastfeeding was 98.0% (95% CI: 95.0%, 99.2%). Sensitivities were 97.3% (95% CI: 93.9%, 98.9%) for identifying any breastfeeding and 94.4% (95% CI: 89.7%, 97.0%) for exclusive breastfeeding, and positive predictive values were 99.5% (95% CI: 97.0%, 99.9%) for any breastfeeding and 95.0% (95% CI: 90.4%, 97.4%) for exclusive breastfeeding.
Conclusions
Breastfeeding information in structured EHR fields have the potential to accurately classify lactation status. The validity of these data should be assessed in populations with a lower breastfeeding prevalence.</description><subject>Adult</subject><subject>Babies</subject><subject>Breast feeding</subject><subject>Breast Feeding - statistics & numerical data</subject><subject>Breast milk</subject><subject>breastfeeding</subject><subject>Breastfeeding & lactation</subject><subject>Electronic health records</subject><subject>Electronic Health Records - statistics & numerical data</subject><subject>Electronic medical records</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health informatics</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Lactation</subject><subject>Lactation - physiology</subject><subject>Maternal & child health</subject><subject>Milk, Human - chemistry</subject><subject>Pediatrics</subject><subject>pharmacoepidemiology</subject><subject>Pharmacoepidemiology - methods</subject><subject>Postpartum period</subject><subject>Reproducibility of Results</subject><subject>Sensitivity analysis</subject><subject>validation study</subject><issn>0269-5022</issn><issn>1365-3016</issn><issn>1365-3016</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9OHSEUh0lTU29tF32BhqQbuxjlz8AMy-ZGWxMTXeiaIBx6McwwhRkbH6LvLDrWhYlsDifnOx8kP4S-UHJE6zmeJjiinAj6Dm0ol6LhhMr3aEOYVI0gjO2jj6XcEkKkUOwD2ud9q1rO5Qb92-5MNnaGHIqZQxqxGR2-MzG4tU0exzpfmzD6lIf17nMacJnzYuclg8MQwc45jcHiHZg473AGm7IruO7gpUDdxlN9bTA2wRQcDCHF9DtYE6tncQHKJ7TnTSzw-bkeoOvTk6vtr-b84ufZ9sd5YznltDGkhRvOWkGl73tpBQglrfGMAKOt4ULxXoIi0FsuvHTUgW-V9G1HO04d4wfocPVOOf1ZoMx6CMVCjGaEtBTNlOyIJITRin57hd6mJY_1d5oT1SnOOv4o_L5SNqdSMng95TCYfK8p0Y8Z6ZqRfsqosl-fjcvNAO6F_B9KBY5X4G-IcP-2SV9enqzKB3tina4</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Mohamed, Hibo H.</creator><creator>Ehresmann, Kirsten</creator><creator>Seburg, Elisabeth M.</creator><creator>Vazquez‐Benitez, Gabriela</creator><creator>Demerath, Ellen W.</creator><creator>Fields, David A.</creator><creator>Vesco, Kimberly K.</creator><creator>Kharbanda, Elyse O.</creator><creator>Palmsten, Kristin</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0134-6228</orcidid></search><sort><creationdate>202408</creationdate><title>Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies</title><author>Mohamed, Hibo H. ; Ehresmann, Kirsten ; Seburg, Elisabeth M. ; Vazquez‐Benitez, Gabriela ; Demerath, Ellen W. ; Fields, David A. ; Vesco, Kimberly K. ; Kharbanda, Elyse O. ; Palmsten, Kristin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3131-a04eb324516f886c5e596caf20e214a359386e90e8c35f6d1def496f471731d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Babies</topic><topic>Breast feeding</topic><topic>Breast Feeding - statistics & numerical data</topic><topic>Breast milk</topic><topic>breastfeeding</topic><topic>Breastfeeding & lactation</topic><topic>Electronic health records</topic><topic>Electronic Health Records - statistics & numerical data</topic><topic>Electronic medical records</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health informatics</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Lactation</topic><topic>Lactation - physiology</topic><topic>Maternal & child health</topic><topic>Milk, Human - chemistry</topic><topic>Pediatrics</topic><topic>pharmacoepidemiology</topic><topic>Pharmacoepidemiology - methods</topic><topic>Postpartum period</topic><topic>Reproducibility of Results</topic><topic>Sensitivity analysis</topic><topic>validation study</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mohamed, Hibo H.</creatorcontrib><creatorcontrib>Ehresmann, Kirsten</creatorcontrib><creatorcontrib>Seburg, Elisabeth M.</creatorcontrib><creatorcontrib>Vazquez‐Benitez, Gabriela</creatorcontrib><creatorcontrib>Demerath, Ellen W.</creatorcontrib><creatorcontrib>Fields, David A.</creatorcontrib><creatorcontrib>Vesco, Kimberly K.</creatorcontrib><creatorcontrib>Kharbanda, Elyse O.</creatorcontrib><creatorcontrib>Palmsten, Kristin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Paediatric and perinatal epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohamed, Hibo H.</au><au>Ehresmann, Kirsten</au><au>Seburg, Elisabeth M.</au><au>Vazquez‐Benitez, Gabriela</au><au>Demerath, Ellen W.</au><au>Fields, David A.</au><au>Vesco, Kimberly K.</au><au>Kharbanda, Elyse O.</au><au>Palmsten, Kristin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies</atitle><jtitle>Paediatric and perinatal epidemiology</jtitle><addtitle>Paediatr Perinat Epidemiol</addtitle><date>2024-08</date><risdate>2024</risdate><volume>38</volume><issue>6</issue><spage>505</spage><epage>514</epage><pages>505-514</pages><issn>0269-5022</issn><issn>1365-3016</issn><eissn>1365-3016</eissn><abstract>Background
Breastfeeding information stored within electronic health records (EHR) has recently been used for pharmacoepidemiological research, however the data are primarily collected for clinical care.
Objectives
To characterise breastfeeding information recorded in structured fields in EHR during infant and postpartum health care visits, and to assess the validity of lactation status based on EHR data versus maternal report at research study visits.
Methods
We assessed breastfeeding information recorded in structured fields in EHR from one health system for a subset of 211 patients who were also enrolled in a study on breast milk composition between 2014 and 2017 that required participants to exclusively breastfeed their infants until at least 1 month of age. We assessed the frequency of breastfeeding information in EHR during the first 12 months of age and compared lactation status based on EHR with maternal report at 1 and 6‐month study visits (reference standard).
Results
The median number of breastfeeding records in the EHR per infant was six (interquartile range 3) with most observations clustering in the first few weeks of life and around well‐infant visits. At the 6‐month study visit, 93.8% of participants were breastfeeding and 80.1% were exclusively breastfeeding according to maternal report. Sensitivity of EHR data for identifying ever breastfeeding was at or near 100%, and sensitivity for identifying ever exclusive breastfeeding was 98.0% (95% CI: 95.0%, 99.2%). Sensitivities were 97.3% (95% CI: 93.9%, 98.9%) for identifying any breastfeeding and 94.4% (95% CI: 89.7%, 97.0%) for exclusive breastfeeding, and positive predictive values were 99.5% (95% CI: 97.0%, 99.9%) for any breastfeeding and 95.0% (95% CI: 90.4%, 97.4%) for exclusive breastfeeding.
Conclusions
Breastfeeding information in structured EHR fields have the potential to accurately classify lactation status. The validity of these data should be assessed in populations with a lower breastfeeding prevalence.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38494336</pmid><doi>10.1111/ppe.13051</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0134-6228</orcidid></addata></record> |
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| identifier | ISSN: 0269-5022 |
| ispartof | Paediatric and perinatal epidemiology, 2024-08, Vol.38 (6), p.505-514 |
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| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adult Babies Breast feeding Breast Feeding - statistics & numerical data Breast milk breastfeeding Breastfeeding & lactation Electronic health records Electronic Health Records - statistics & numerical data Electronic medical records Epidemiology Female Health informatics Humans Infant Infant, Newborn Infants Lactation Lactation - physiology Maternal & child health Milk, Human - chemistry Pediatrics pharmacoepidemiology Pharmacoepidemiology - methods Postpartum period Reproducibility of Results Sensitivity analysis validation study |
| title | Characterisation and validation of lactation information from structured electronic health records for use in pharmacoepidemiological studies |
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