Documented Statin Exposure and Multiple Sclerosis in Southeast Alabama

BackgroundStatins inhibit cholesterol biosynthesis and may influence central nervous system repair through lipiddependent and immunomodulatory pathways.Preclinical and clinical evidence concerning statins in multiple sclerosis (MS) has been inconsistent.This pilot study examined whether documentation of MS among decedents differed according to documented statin exposure and evaluated the feasibility of an institutional electronic medical record research workflow. MethodsWe conducted an exploratory retrospective review of 26,710 rows from an Epic-generated report structured as one row per decedent recorded as deceased from February 2021 through July 14, 2025 at a regional health system in southeast Alabama.The rows were treated as unique decedents, although duplicate identifiers were not independently audited.The records were classified according to the presence or absence of documented statin exposure.The clinical outcome was explicit MS documentation in the report.Fisher's exact test was the primary inferential analysis because the outcome was rare.Operational feasibility was described by completion of the institutional approval, secure access, report generation, and record review process. ResultsDocumented statin exposure was present in 3,025 records and absent in 23,685.MS was documented in 10 records, including eight with documented statin exposure (0.264%) and two without documented exposure (0.008%).Fisher's exact test showed an unadjusted association between statin documentation and MS documentation (conditional odds ratio: 31.39,exact 95% confidence interval: 6.26 to 303.58; p = 9.78 × 10⁻⁷).The institutional workflow produced a project-specific report in a secure environment and supported completion of the record review.Only 10 outcome events were available, so adjusted modeling was not performed. ConclusionsMS was more frequently documented among decedents whose records also documented statin exposure.Because every record represented a decedent and exposure ascertainment depended on the available documentation, the analysis cannot estimate the effect of statins on mortality, MS onset, or MS progression.The clinical result is hypothesis-generating.This pilot study also demonstrates that a governed pathway for student-led electronic medical record research can be implemented within a regional health system.