Title | Imputing Missing Race/Ethnicity in Pediatric Electronic Health Records: Reducing Bias with Use of U.S. Census Location and Surname Data. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Grundmeier RW, Song L, Ramos MJ, Fiks AG, Elliott MN, Fremont A, Pace WD, Wasserman RC, Localio R |
Journal | Health Serv Res |
Volume | 50 |
Issue | 4 |
Pagination | 946-60 |
Date Published | 08/2015 |
ISSN | 1475-6773 |
Abstract | OBJECTIVE: To assess the utility of imputing race/ethnicity using U.S. Census race/ethnicity, residential address, and surname information compared to standard missing data methods in a pediatric cohort. DATA SOURCES/STUDY SETTING: Electronic health record data from 30 pediatric practices with known race/ethnicity. STUDY DESIGN: In a simulation experiment, we constructed dichotomous and continuous outcomes with pre-specified associations with known race/ethnicity. Bias was introduced by nonrandomly setting race/ethnicity to missing. We compared typical methods for handling missing race/ethnicity (multiple imputation alone with clinical factors, complete case analysis, indicator variables) to multiple imputation incorporating surname and address information. PRINCIPAL FINDINGS: Imputation using U.S. Census information reduced bias for both continuous and dichotomous outcomes. CONCLUSIONS: The new method reduces bias when race/ethnicity is partially, nonrandomly missing. |
DOI | 10.1111/1475-6773.12295 |
Alternate Journal | Health Serv Res |
PubMed ID | 25759144 |
PubMed Central ID | PMC4545341 |
Grant List | P30 HS021645 / HS / AHRQ HHS / United States UB5MC20286 / / PHS HHS / United States |