Objective:

To analyze the documentation of menopause in self-reported surveys compared to structured electronic health records (EHRs) in the All of Us Research Program.

Approach:

• Data Analysis: Investigators analyzed menopause-related survey responses, EHR diagnosis codes, and genomic data from approximately 396,000 participants recorded as female at birth.
• Survey Measures: Included questions on permanent cessation of menstrual periods, reasons for cessation, hysterectomy history, and ovary removal.
• EHR Measures: Included structured diagnostic codes for menopause, premature menopause, and related conditions.

Key Findings:

• 192,655 participants reported permanent cessation of menstrual periods, while only 27,975 had an EHR diagnosis code for menopause.
• Surveys identified nearly 7 times as many menopause observations compared to structured EHR data.
• Among participants with an EHR menopause diagnosis, over 99% reported that their periods had permanently stopped.
• 18% of participants with natural and surgical menopause had an EHR menopause diagnosis.
• EHR data showed limited documentation of menopause-related symptoms.

Interpretation:

The findings indicate substantial underreporting of menopause in structured EHRs compared to self-reported surveys.

Limitations:

• Menopause status was not clinically confirmed.
• Survey and EHR data did not provide age at natural menopause.
• Response and recall bias may affect survey results.
• Small sample sizes in some sociodemographic groups limit interpretation.

Conclusion:

Survey data provided greater ascertainment of menopause than structured EHR diagnoses.

Sources:

• Menopause