Integrated Analysis for Electronic Health Records with Structured and Sporadic Missingness

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Main Authors: Tan, Jianbin, Zhang, Yan, Hong, Chuan, Cai, T. Tony, Cai, Tianxi, Zhang, Anru R.
Format: Preprint
Published: 2025
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author Tan, Jianbin
Zhang, Yan
Hong, Chuan
Cai, T. Tony
Cai, Tianxi
Zhang, Anru R.
author_facet Tan, Jianbin
Zhang, Yan
Hong, Chuan
Cai, T. Tony
Cai, Tianxi
Zhang, Anru R.
contents Objectives: We propose a novel imputation method tailored for Electronic Health Records (EHRs) with structured and sporadic missingness. Such missingness frequently arises in the integration of heterogeneous EHR datasets for downstream clinical applications. By addressing these gaps, our method provides a practical solution for integrated analysis, enhancing data utility and advancing the understanding of population health. Materials and Methods: We begin by demonstrating structured and sporadic missing mechanisms in the integrated analysis of EHR data. Following this, we introduce a novel imputation framework, Macomss, specifically designed to handle structurally and heterogeneously occurring missing data. We establish theoretical guarantees for Macomss, ensuring its robustness in preserving the integrity and reliability of integrated analyses. To assess its empirical performance, we conduct extensive simulation studies that replicate the complex missingness patterns observed in real-world EHR systems, complemented by validation using EHR datasets from the Duke University Health System (DUHS). Results: Simulation studies show that our approach consistently outperforms existing imputation methods. Using datasets from three hospitals within DUHS, Macomss achieves the lowest imputation errors for missing data in most cases and provides superior or comparable downstream prediction performance compared to benchmark methods. Conclusions: We provide a theoretically guaranteed and practically meaningful method for imputing structured and sporadic missing data, enabling accurate and reliable integrated analysis across multiple EHR datasets. The proposed approach holds significant potential for advancing research in population health.
format Preprint
id arxiv_https___arxiv_org_abs_2506_09208
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Integrated Analysis for Electronic Health Records with Structured and Sporadic Missingness
Tan, Jianbin
Zhang, Yan
Hong, Chuan
Cai, T. Tony
Cai, Tianxi
Zhang, Anru R.
Applications
Computation
Methodology
Machine Learning
Objectives: We propose a novel imputation method tailored for Electronic Health Records (EHRs) with structured and sporadic missingness. Such missingness frequently arises in the integration of heterogeneous EHR datasets for downstream clinical applications. By addressing these gaps, our method provides a practical solution for integrated analysis, enhancing data utility and advancing the understanding of population health. Materials and Methods: We begin by demonstrating structured and sporadic missing mechanisms in the integrated analysis of EHR data. Following this, we introduce a novel imputation framework, Macomss, specifically designed to handle structurally and heterogeneously occurring missing data. We establish theoretical guarantees for Macomss, ensuring its robustness in preserving the integrity and reliability of integrated analyses. To assess its empirical performance, we conduct extensive simulation studies that replicate the complex missingness patterns observed in real-world EHR systems, complemented by validation using EHR datasets from the Duke University Health System (DUHS). Results: Simulation studies show that our approach consistently outperforms existing imputation methods. Using datasets from three hospitals within DUHS, Macomss achieves the lowest imputation errors for missing data in most cases and provides superior or comparable downstream prediction performance compared to benchmark methods. Conclusions: We provide a theoretically guaranteed and practically meaningful method for imputing structured and sporadic missing data, enabling accurate and reliable integrated analysis across multiple EHR datasets. The proposed approach holds significant potential for advancing research in population health.
title Integrated Analysis for Electronic Health Records with Structured and Sporadic Missingness
topic Applications
Computation
Methodology
Machine Learning
url https://arxiv.org/abs/2506.09208