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EHR Quality Improvement Study Detects Demographic-Related Deficiencies in Cancer Family History Data

In JAMA Network Open, investigators at the University of Utah's Huntsman Cancer Institute, New York University, and elsewhere consider potential differences between individuals' family history information (FHI) and the information in their electronic health records (EHR), particularly in relation to family cancer history. The team retrospectively analyzed EHR data for more than 522,100 individuals between the ages of 25 and 60 years old who visited the University of Utah Health or NYU Langone Health systems for primary care appointments in the three years leading up to the analysis. They uncovered significant disparities in the quality and completeness of family history information in individuals' EHR — a problem that appeared to be especially pronounced in African American, Hispanic, or Latino patients, patients who spoke Spanish, and male patients. "These findings suggest that systematic differences in the availability and comprehensiveness of FHI in the EHR may introduce informative presence bias as inputs to [clinical decision support] algorithms," the authors report, explaining that "observed differences may also exacerbate disparities for medically underserved groups."