Once you have determined which patients seem pertinent to your research inquiry, the next step is usually to review their charts.
The Cohort Discovery Tool and Chart Review Tool share the same URL, https://stride-service.stanford.edu/stride/web. To switch from the Cohort Discovery Tool to the Chart Review tool, either click the "Go to Chart Review" toolbar button, or select "Patient Chart Review" from the dropdown menu in the center of the Cohort Discovery Tool's toolbar.
If you do not see this option in your drop-down, please follow our step-by-step guide to the process of obtaining all requisite institutional approvals.
The Chart Review Tool User's Guide is well worth reading as it describes several very handy features of the tool. But very briefly, the first thing you see when switching to Chart Review is your patient list. In this view you can filter the list by typing in the search box in the upper right (see "Search" in the annotated image below), switch to a different list if you have more than one by clicking the name of the saved cohort in the upper left (see "Switch Lists" below), or open the chart of a single patient by double-clicking on a row in the main list ("View Chart").
You can filter the list by the associated tags by clicking on the "Any Tag" dropdown ("Filter by Tag"). You can also search individual chart for keywords; doing so will filter the list of items displayed (see "Search", above). For details on how this powerful feature works and an explanation of the advanced search syntax, please consult the Users's Guide.
When you double-click on a row (see "View Chart", above), you are taken to that patient's chart. Once in a chart, you can search for keywords in the upper right (circled in red in the image below); the matching terms will be highlighted in yellow in the chart. Click "Show All" to clear your search. You can also show/hide clinical data types by selecting the "Event Filter" checkboxes on the left hand side. To navigate between patients, click the green forward/back arrows in the toolbar. To return to the patient list, click on "< Patient List" in the far left of the toolbar.
If you wish to work with the underlying data in .csv file format, you can use the "data download" feature.
If you wish to limit the dataset by date range, enter a start and end date. Both are optional.
As of Spring 2023, the clinical data files available for download consist of patient demographics, encounters, diagnoses, procedures, lab results, flowsheets records, medication orders and administration, clinical notes and documents, radiology reports, pathology reports, SMART data elements, Epic Questionnaires, treatment teams, and immunizations.
In support of HIPAA Minimum Necessary, all clinical data files use the patient "anon id" as the study code to identify the patient. Furthermore all download files are scrubbed of PHI. If your research program requires working with downloaded PHI, you can request an exemption to this policy.
Studies with data privacy permission to see patient identifiers get a patient identifier codebook as part of the data set available for download. The identifier codebook (aka crosswalk) is intended for dataset linkage and quality assurance use only and should not be shared with the researchers doing data analysis.
Note: If you experience difficulty downloading files, try Chrome or Firefox.
The data dictionary is available to everyone at Stanford; if asked to do so, simply log into Google using your firstname.lastname@example.org credentials.
Chart Review Settings Administration
The person who creates a chart review is automatically made into the administrator of the cohort. Administrators can change the cohort name, add and remove users, and enable or disable active cohort monitoring.
To make changes to these settings, click on the gear icon in the upper left. If you see a blue "i" info-button icon rather than a gear, you are not an administrator of the cohort, but clicking on the button will tell you who is an administrator.
"Deleting" a Chart Review
Because cohorts are typically shared between multiple members of a research team, the only way to delete a cohort from your workspace is to remove yourself from it.
To remove yourself from a cohort, go to the patient list screen, click on the settings button in the toolbar (the gear icon), locate yourself on the list of collaborators, and click "Remove".
Note that the server will double check your MRNs and notify you if any seem to be incorrect. It will also silently discard MRNs that are already included in your cohort, so you don't wind up with duplicate charts. If you find that fewer new records were added than you expect, double check your existing cohort for any overlap with the MRNs you tried to upload.