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Electronic medical records (EMRs) are increasingly being used by health services including those that test for and treat sexually transmitted infections (STIs).1–3 The implementation of EMRs opens up new opportunities for improving the quality, effectiveness and efficiency of sexual health services and brings with it the potential for enhanced research capacity.1–3 Information from routinely collected health data can and should be leveraged for the evaluation of clinical services to improve STI and HIV care and to measure the impact of interventions aimed at curbing STI. This information has already been captured and, if appropriately harnessed, constitutes a rich repository of data that can be used for research.
Because information in EMRs has generally been gathered for patient management rather than to answer research questions, the use of such data for studies introduces potential limitations and biases. When examining treatment outcomes retrospectively for instance, observational studies will naturally fall short of rigorously conducted randomised trials. However, prospective trials can be prohibitively expensive and their results may not be generalisable to diverse real world settings and populations. In addition, observational research carries with it specific …