The Georges Pompidou University Hospital i2b2 Warehouse: learning and feedback from 8-years experience
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1 The Georges Pompidou University Hospital i2b2 Warehouse: learning and feedback from 8-years experience Anne-Sophie Jannot, Eric Zapletal, Paul Avillach Marie-France Mamzer, Anita Burgun, Patrice Degoulet
2 CDW challenges Data integration Data gouvernance Data valorisation / processing
3 CDW integration in HEGP hospital (2009-) Extract / Transform / Load (Talend Open Studio) CIS Operational database CIS: Replicated database Clinical datawarehouse Patient medical record Prescription Clinical reports Laboratory values Concept Patient Modifier FACTS Entrepôt de données Provider Encounter
4 HEGP CDW sources and volumetry (current figures) Number of HEGP CDW data sources observations (millions) Demographic patient data (gender, age, family status and vital status) 1.6 Biology and pathology results Drug prescriptions and pharmacists validations 11.4 Final diagnosis 8.4 Procedures 5.4 Diagnoses and procedures coded using legacy terminologies (DRG) 1.2 Patient pathways 7.1 Electronic Health Record (EHR) structured forms items Clinical and imagery text reports 4.1 Clinical parameters (heart frequency, temperature, ) 14.2 Chemotherapy prescriptions 1.4 Nurses notes 18.9 Radiation therapy data < 0.1
5 Data governance (2011-): patients information Institutional review board Right to refuse Patients involvement
6 Data governance (2011-): definition of several levels of data access First level : aggregated data All physicians and pharmacist from HEGP having participated to a training session on i2b2 Training sessions opened to all physicians and pharmacist including residents
7 Data governance (2011-): aggregated data access
8 Data governance (2011-): aggregated data access
9 Data governance (2011-): aggregated data access
10 Data governance (2011-): definition of several levels of data access First level : aggregated data All physicians and pharmacist from HEGP having participated to a training session on i2b2 Training sessions opened to all physicians and pharmacist including residents Level 2 and 3 : individual data (IRB) Level 2 : encoded identifiers Level 3: hospital identifier or complete name
11 Data governance (2011-): access to individual data for a research project Research protocol IRB assessment Research datamart Are all units having produced relevant data for the project involved in the research? Analysis: vizualisation tool, statistical support
12 Escudié J-B, Jannot A-S, Zapletal E, Cohen S, Malamut G, Burgun A, et al. Reviewing 741 patients records in two hours with FASTVISU. AMIA Annu Symp. Proc AMIA Symp AMIA Symp. 2015; 2015:
13 Year Number of projects Data valorisation (2011-): projects approved by local IRB Number of bioclinical departments Clinical epidemiology Health service research Clinical Research Total (%) (79%) 46 (49%) 45 (47%) 4 (4%)
14 Data valorisation (2011-): an epidemiological study on a rare condition Matched case control study Large inclusion period Rare disease Pettenati, C., Jannot, A. S., Hurel, S., Verkarre, V., Kreis, H., Housset, M.,... & Timsit, M. O. (2016). Prostate Cancer Characteristics and Outcome in Renal Transplant Recipients: Results from a Contemporary Monocentric Study. Clinical transplantation.
15 Data valorisation (2011-): an health service research on prescription practice evaluation Odds of women being treated by a given class of anti-hypertensive drug at the first consultation compared to men after adjustment over the period Reuse of data from hypertension consultation Deborde, T., Amar, L., Bobrie, G., Postel-Vinay N, Battaglia C, Tache A, Chedid A, Dhib MM, Chatellier, G., Plouin PF, Burgun, A., Azizi M, Jannot, AS. Sex differences in antihypertensive treatment in France among 17,856 patients in a tertiary hypertension unit. Journal of hypertension, 2017.
16 Data valorisation (2011-): a clinical research project on patient recruitment Girardeau, Y., Doods, J., Zapletal, E., Chatellier, G., Daniel, C., Burgun, A.,... & Rance, B. (2017). Leveraging the EHR4CR platform to support patient inclusion in academic studies: challenges and lessons learned. BMC medical research methodology, 17(1), 36.
17 Learning and feedback Data governance is central Clinical researchers often ignore clinical data complexity (thousands of concepts) Clinicians not prepared to formulate complex queries and navigate through the different nomenclatures that populate a CDW. Strong collaboration between clinicians, biomedical informatics, biostatistics and epidemiology specialists is needed to complete successfully research project using a CDW
18 Perspectives Link with other datawarehouse (AP-HP, SNIIRAM) Integration of other types of data (omics, patient reported outcomes)
19 The Georges Pompidou University Hospital i2b2 Warehouse: learning and feedback from 8-years experience Anne-Sophie Jannot, Eric Zapletal, Paul Avillach Marie-France Mamzer, Anita Burgun, Patrice Degoulet
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