Can we trust Electronic health records? The Smoking Test for Commission Errors.

Pablo Millares Martin


Background: Considerable interest exists on using general practice electronic health records (EHR) for research and other uses. There is also concern on their quality.

Aim: We suggest a simple test to assess errors of commission and in consequence overall EHR data quality that can be done on a periodical basis.

Method: Patient records with simultaneous entries of three different stages on smoking were studied. The codes “Never smoked tobacco”, “smoker” and “ex-smoker” should follow this chronological order. It should then be possible to extrapolate the overall level of errors of commission for the organisation.

Results: The Smoking Test in our sample found errors in 169 patients, with 60 cases where dual errors were discovered. We express it as an estimated error of commission level of 2.6% related to the total population of the practice.

Conclusions: Considering the constant and regular entries on smoking status (83.59% of the entries were done over last month), we can conclude smoking entries analysis can serve as a simple test to periodically assess the overall EHR data quality, and any trends.


Data quality; electronic health records; commission error.

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