Corroboration should survive a second coding environment
by Lian Cross
An EHR study conducted after a spontaneous-report signal should distinguish replication of the event pattern from reuse of the same documentation process. A second site adds little if both systems inherit the same claims feed, coding rule, or post-recognition diagnosis field.
At each site, define the exposed cohort and observation window before comparing event counts. Map the phenotype across coding systems, collapse repeated encounters into patient-level episodes, and report exclusions separately. The comparison should show event rates and uncertainty, not only the number of matching codes.
Agreement across independently constructed phenotypes provides stronger external corroboration than agreement produced by a shared coding artifact. It still does not convert an observed association into a causal effect.
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