Using big data to improve cardiovascular care and outcomes in China: a protocol for the CHinese Electronic health Records Research in Yinzhou (CHERRY) Study

Hongbo Lin, Xun Tang, Peng Shen, Dudan Zhang, Jinguo Wu, Jingyi Zhang, Ping Lu, Yaqin Si, Pei Gao, Hongbo Lin, Xun Tang, Peng Shen, Dudan Zhang, Jinguo Wu, Jingyi Zhang, Ping Lu, Yaqin Si, Pei Gao

Abstract

Introduction: Data based on electronic health records (EHRs) are rich with individual-level longitudinal measurement information and are becoming an increasingly common data source for clinical risk prediction worldwide. However, few EHR-based cohort studies are available in China. Harnessing EHRs for research requires a full understanding of data linkages, management, and data quality in large data sets, which presents unique analytical opportunities and challenges. The purpose of this study is to provide a framework to establish a uniquely integrated EHR database in China for scientific research.

Methods and analysis: The CHinese Electronic health Records Research in Yinzhou (CHERRY) Study will extract individual participant data within the regional health information system of an eastern coastal area of China to establish a longitudinal population-based ambispective cohort study for cardiovascular care and outcomes research. A total of 1 053 565 Chinese adults aged over 18 years were registered in the health information system in 2009, and there were 23 394 deaths from 1 January 2009 to 31 December 2015. The study will include information from multiple epidemiological surveys; EHRs for chronic disease management; and health administrative, clinical, laboratory, drug and electronic medical record (EMR) databases. Follow-up of fatal and non-fatal clinical events is achieved through records linkage to the regional system of disease surveillance, chronic disease management and EMRs (based on diagnostic codes from the International Classification of Diseases, tenth revision). The CHERRY Study will provide a unique platform and serve as a valuable big data resource for cardiovascular risk prediction and population management, for primary and secondary prevention of cardiovascular events in China.

Ethics and dissemination: The CHERRY Study was approved by the Peking University Institutional Review Board (IRB00001052-16011) in April 2016. Results of the study will be disseminated through published journal articles, conferences and seminar presentations, and on the study website (http://www.cherry-study.org).

Keywords: Chinese; cardiovascular diseases; electronic health records.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Study location for the CHinese Electronic health Records Research in Yinzhou (CHERRY) study.
Figure 2
Figure 2
Data sources for establishing the CHinese Electronic health Records Research in Yinzhou (CHERRY) cohort. Notes: Although the main focus of the CHERRY Study is on adults, data sources of infants, children and pregnant women are included in the health information system, for example, birth weight from birth certificates. However, birth records are generally not available for adults who were already over 18 years old in 2009. Maternal exposures from antenatal examination records, that is, gestational hypertension or diabetes, were recorded in the system which can be potential risk factors for cardiovascular disease (CVD) prediction in women. However, a further ethics review process is required to extract maternal information in CHERRY.

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