The Limitations of Large Longitudinal Data Sets

The study had several limitations including using data from a single center tertiary referral center that could bias our results to have more severe outcomes. We also do not have you know lupus disease activity like sleeti or damage scores as these aren't routinely collected as part of clinical care. There's missingness in EHR data due to the fragmented health care system we have in the US so records from outside our institution are not always available. Some of the older data certainly is more kind of dictated letters and notes not the kind of templated notes that we see with newer more modern EHR systems.