大坏数据：法律、公共卫生、 和生物医学数据库.pdf

BigBadData:Law,PublicHealth,

andBiomedicalDatabases

SharonaHoffmanandAndyPodgurski

heacceleratingadoptionofelectronichealthmentbias.Theseandotherobstaclescaneasilylead

record(EHR)systemswillhaveprofoundtoinvalidconclusionsandunsoundpublichealth

Timpactsonclinicalcare.Itwillalsohavefar-policies.

reachingimplicationsforpublichealthresearchandThepaperwillhighlightthepublichealthusesof

surveillance,whichinturncouldleadtochangesinEHRs.ItwillalsoprobetheshortcomingsofEHR

publicpolicy,statutes,andregulations.Thepublicinformationandthechallengesofcollectingandana-

healthbenefitsofEHRusecanbesignificant.How-lyzingit.Althoughsomeoftheproblemswediscuss

ever,researchersandanalystswhorelyonEHRdataapplytoallresearch,includingthatbasedonpaper

mustproceedwithcautionandunderstandthepoten-records,theywillbecomeallthemoretroublingand

tiallimitationsofEHRs.importantinaneraofelectronic“bigdata,”inwhich

MuchhasbeenwrittenabouttheriskofEHRpri-massiveamountsofdataareprocessedautomatically,

1withouthumanchecks.Finally,weoutlineseveralreg-

vacybreaches.Thispaperfocusesonadifferentsetof

concerns,thoserelatingtodataquality.Unlikeclini-ulatoryandotherinterventionstoaddressdataanaly-

caltrialdata,EHRdataisnotrecordedprimarilytosisdifficulties.

meettheneedsofresearchers.Becauseofclinicians’

workloads,pooruser-interfacedesign,andotherfac-PublicHealthBenefitsofEHRs

tors,EHRdataissurprisinglylikelytobe