Journal Summary

Electronic Versus Manual Data Processing: Evaluating the Use of

Electronic Health Records in Out-of-Hospital Clinical Research

Zulkifli B. Pomalango

176070300111010

By lecturer : Ns. Dewi Kartikawatiningsih, S.Kep, M.Ph

Master of Nursing Faculty of Medicine

Brawijaya University

2017
 Journal Summary

Zulkifli B. Pomalango. Email : zulkifli@ung.ac.id

Master of Nursing Faculty of Medicine
Brawijaya University

Electronic Versus Manual Data Processing: Evaluating the Use of

Electronic Health Records in Out-of-Hospital Clinical Research
Craig D. Newgard, MD, MPH, Dana Zive, MPH, Jonathan Jui, MD, MPH, Cody Weathers,
BS, and Mohamud Daya, MD, MS

This literature compares several aspects of data collection and processing

among a group of trauma patients outside the hospital using two separate
strategies: electronic data processing and a more conventional manual data
processing approach. The evaluation strategy in this literature uses three aspects
of data collection and processing:1) data capture (case ascertainment), 2) data
quality (agreement, validity), and 3) differences in the proportion of missing
values.
This study used secondary data with retrospective cohort method. The
sample used in the study was a group of trauma patients who had been
discharged from the hospital. In this study collected the same sample data
between patient data using electronic or manual system. There were 418
samples.
This study was conducted with 10 emergency medical service agencies
(EMS) (four private ambulance transport agents, six firefighters) and 16 hospitals
(three trauma centers, 13 public hospitals or private hospitals) in the four areas of
Northwest Oregon and Southwest Washington. This area operates dual-
advanced dual life support systems.
The results of research based on three aspects of the assessment of data
collection and processing obtained :
1. Data capture (case ascertainment)
In the processing of manual and electronic data using clinical information,
operational and result of different data, consists of initial field vital signs,
worst field vital signs, time intervals, field procedures, and autcomes. Earn
identification using electronic has good value compared to manual. For
example, lower GCS, higher percentage of intubation in the field and a
 worse prognosis in mortality. The mortality rate was lower in electronics at
18% compared with 27% manual use.
2. Data quality (agreement, validity)
Use value agreement (kappa 0.76 to 0.97; intraclass correlation
coefficient 0.49 to 0.97), with exact agreement in 67% to 99% of cases,
and a median difference of zero for all continuous and ordinal variables.
The results of data processing obtained there is the right deal for use
electronically, kappa values ranged from 0.76 (intravenous line
placement) to 0.97 (intubation attempt), with exact agreement from 67%
to 99%. The intraclass correlation coefficient (ICC) for continuous terms
ranged from 0.49 (response interval) to 0.97 (transport and total out of
hospital intervals), and tended to be higher for variables measured
throughout the out-of-hospital time period as opposed to single. The
median difference was zero for all continuous variables, with all but two
terms having an interquartile range (IQR) of zero for these differences. In-
hospital mortality agreed exactly in 99% of cases (kappa 0.96), while
hospital length of stay agreed exactly in 62% of cases (ICC 0.56).
3. Differences in the proportion of missing values
During the 21 month period, 629 injured patients with physiologic
compromise were identified, enrolled, and processed using manual data
processing. Case ascertainment using electronic methods yielded 3,008
injured patients meeting the same inclusion criteria during the same time
period.
Based on the above description can be concluded for out-of-hospital
trauma patients, an all-electronic data processing strategy identified more
patients and generated values with good agreement and validity compared to
traditional data collection and processing methods.