A Biostatistics Seminar Series hosted by the NYU GPH Department of Biostatistics
Featuring:
Rebecca Hubbard, PhD
Professor of Biostatistics & Data Science, Brown University School of Public Health
Abstract: Data are captured in electronic health records (EHRs) as a direct result of patient interactions with the healthcare system. Consequently, EHR data for patients with more healthcare utilization tend to be captured more frequently and provide more detail about the patient’s health. This connection between patterns of healthcare utilization and data quantity and quality, termed informed presence, violates the common statistical assumption of independence between observation and outcome processes. This is particularly problematic for historically marginalized populations and other groups experiencing barriers to healthcare. Limited data availability has the potential to increase bias, imprecision and algorithmic unfairness in EHR-based research results for these medically underserved groups. In this presentation, Dr. Hubbard will discuss the roots of informed presence bias in EHR data and illustrate examples of informed presence bias using real-world EHR data on childhood mortality and breast cancer outcomes. She will quantify the magnitude of bias resulting from alternative patterns of dependence between outcome and exposure data capture and healthcare utilization intensity and demonstrate several solutions to this problem. While EHR data can be used to accelerate precision medicine, achieving this goal while also safeguarding equity for underserved populations requires careful attention to data provenance and analytic methods.
About the speaker: Dr. Rebecca Hubbard is Professor of Biostatistics and Data Science at the Brown University School of Public Health. Her research focuses on development and application of statistical methods for studies using data from electronic health records (EHR) and medical claims, including issues of data availability and quality, and has been applied to studies in aging, oncology and pharmacoepidemiology. She is a Fellow of the American Statistical Association, Co-Editor of the journal Biostatistics and a Statistical Editor for the New England Journal of Medicine.