Clinical Data and Health Data Types

This chapter introduces readers to clinical data and health data types commonly used in health analytics. We will describe why research is needed using real-world clinical datasets, in addition to carefully curated clinical trials research. Real-world clinical datasets enable increased diversity in terms of race, ethnicity, socioeconomic status, sex, gender, and other aspects of diversity, including disability status. The reason for the increased representativeness in research using real-world clinical data is due to the increased number of individuals who receive clinical care versus those who have the ability, time, and resources to contribute to a clinical trial. Therefore, there remains a pressing need for more research on real-world clinical datasets and we will provide you with an overview of topics that you need to know to embark on this journey. We will cover the common health data types, including electronic health records (EHRs), Medicare and Medicaid data, insurance claims data, and the considerations that must be accounted for when utilizing these respective datasets. We will also introduce clinical terminologies for health data, including diagnostic coding terminologies such as the International Classification of Diseases (ICD), versions 9 and 10, pharmacological drug/medication terminologies, and procedure code terminologies. We will cover how to map free-text code names to these terminologies if a particular dataset is missing an appropriate map and resources that can be used to streamline these processes. We will introduce ontologies, which are formal ways of mapping multiple terminologies together towards a common meaning (SNOMED-CT), along with code aggregation strategies (such as PheCodes). We will touch on legislative differences across state boundaries that impact insurance and claims data due to variations in state laws for insurance companies. We will also touch on this variation as it pertains to EHR data as well. After reading this chapter, you should be able to confidently answer the following questions: