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Background: While electronic health records (EHRs) play a key role in increasing colorectal cancer (CRC) screening by identifying individuals who are overdue, important shortfalls remain., Objectives: As part of the Strategies and Opportunities to STOP Colon Cancer (STOP CRC) study, we assessed the accuracy of EHR codes in identifying patients eligible for CRC screening., Methods: We selected a stratified random sample of 800 study participants from 26 participating clinics, in the Pacific Northwest region of the USA. We compared data obtained through codes in the EHR to conduct a manual chart audit. A trained chart abstractor completed the abstraction of eligible and ineligible patients., Results: Of 520 individuals in need of CRC screening, identified via the EHR, 459 were confirmed through chart review (positive predictive value = 88%). Of 280 individuals flagged as up-to-date in their screening per EHR data, 269 were confirmed through chart review (negative predictive value = 96%). Among the 61 patients incorrectly classified as eligible, 83.6% of disagreements were due to evidence of a prior colonoscopy or referral that was not captured in recognizable fields in the EHR., Conclusions: Our findings highlight importance of better capture of past screening events in the EHR. While the need for better population-based data is not unique to CRC screening, it provides an important example of the use of population-based data not only for tracking care, but also for delivering interventions., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: In 1999, the first reporting year of the Health Plan Employer Data and Information Set, our organization noted a significant difference in the proportion of patients with controlled blood pressure (BP) when the target was changed from < 140/90 mm Hg to < or = 140/90 mm Hg. We compared these data with a second larger dataset to determine if these findings were an isolated or common phenomenon and to determine what factors influenced this difference., Study Design and Methods: Subjects were drug-treated hypertensive patients. Blood pressure measurements were taken from outpatient medical records., Results: The percent of hypertensive patients with controlled BP levels was significantly greater (P <.001) when the cutoff of < or = 140/90 mm Hg was used rather than <140/90 mm Hg. When a single BP measurement was used to estimate control, the percent of patients with controlled hypertension increased 12.7% simply by changing the definition to include the level of systolic BP = 140 mm Hg or diastolic BP = 90. When multiple BP readings were used to estimate control, the difference was much less pronounced (2.7%)., Conclusions: When evaluating the success of hypertension treatment, defining BP control as a BP of < or = 140 mm Hg systolic and < or = 90 diastolic mm Hg will result in significantly more people having controlled BP than when <140 mm Hg systolic and <90 mm Hg diastolic are used. This difference is most likely the result of end-digit preference. The use of multiple measures reduces this effect. Policy makers and guideline authors should consider these aspects when setting BP goals.