Importance: Assessing the relative effectiveness and safety of additional treatments when metformin monotherapy is insufficient remains a limiting factor in improving treatment choices in type 2 diabetes.
Objective: To determine whether data from electronic health records across the University of California Health system could be used to assess the comparative effectiveness and safety associated with 4 treatments in diabetes when added to metformin monotherapy.
Design, Setting, And Participants: This multicenter, new user, multidimensional propensity score-matched retrospective cohort study with leave-one-medical-center-out (LOMCO) sensitivity analysis used principles of emulating target trial.
Background: As diagnostic tests for COVID-19 were broadly deployed under Emergency Use Authorization, there emerged a need to understand the real-world utilization and performance of serological testing across the United States.
Methods: Six health systems contributed electronic health records and/or claims data, jointly developed a master protocol, and used it to execute the analysis in parallel. We used descriptive statistics to examine demographic, clinical, and geographic characteristics of serology testing among patients with RNA positive for SARS-CoV-2.
Background: Real-world performance of COVID-19 diagnostic tests under Emergency Use Authorization (EUA) must be assessed. We describe overall trends in the performance of serology tests in the context of real-world implementation.
Methods: Six health systems estimated the odds of seropositivity and positive percent agreement (PPA) of serology test among people with confirmed SARS-CoV-2 infection by molecular test.
This cohort study examines the sensitivity of antibody tests to detect previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by time, test, sex, and age.
View Article and Find Full Text PDFWe describe Pathology Extraction Pipeline (PEP)--a new Open Health Natural Language Processing pipeline that we have developed for information extraction from pathology reports, with the goal of populating the extracted data into a research data warehouse. Specifically, we have built upon Medical Knowledge Analysis Tool pipeline (MedKATp), which is an extraction framework focused on pathology reports. Our particular contributions include additional customization and development on MedKATp to extract data elements and relationships from cancer pathology reports in richer detail than at present, an abstraction layer that provides significantly easier configuration of MedKATp for extraction tasks, and a machine-learning-based approach that makes the extraction more resilient to deviations from the common reporting format in a pathology reports corpus.
View Article and Find Full Text PDFJ Am Med Inform Assoc
August 2014
This article describes the patient-centered Scalable National Network for Effectiveness Research (pSCANNER), which is part of the recently formed PCORnet, a national network composed of learning healthcare systems and patient-powered research networks funded by the Patient Centered Outcomes Research Institute (PCORI). It is designed to be a stakeholder-governed federated network that uses a distributed architecture to integrate data from three existing networks covering over 21 million patients in all 50 states: (1) VA Informatics and Computing Infrastructure (VINCI), with data from Veteran Health Administration's 151 inpatient and 909 ambulatory care and community-based outpatient clinics; (2) the University of California Research exchange (UC-ReX) network, with data from UC Davis, Irvine, Los Angeles, San Francisco, and San Diego; and (3) SCANNER, a consortium of UCSD, Tennessee VA, and three federally qualified health systems in the Los Angeles area supplemented with claims and health information exchange data, led by the University of Southern California. Initial use cases will focus on three conditions: (1) congestive heart failure; (2) Kawasaki disease; (3) obesity.
View Article and Find Full Text PDFAMIA Jt Summits Transl Sci Proc
December 2013
Large-scale comparative effectiveness research studies require detailed clinical data collected across disparate clinical practice settings and institutions. Distributed research networks (DRNs) have been promoted as one approach to wide-scale data sharing that enables data sharing organizations to retain local data ownership and access control. Despite significant investments in distributed data sharing technologies, clinical research networks using distributed methods remain difficult to implement due to a broad range of organizational and technical barriers.
View Article and Find Full Text PDFProgress in our understanding of brain disorders increasingly relies on the costly collection of large standardized brain magnetic resonance imaging (MRI) data sets. Moreover, the clinical interpretation of brain scans benefits from compare and contrast analyses of scans from patients with similar, and sometimes rare, demographic, diagnostic, and treatment status. A solution to both needs is to acquire standardized, research-ready clinical brain scans and to build the information technology infrastructure to share such scans, along with other pertinent information, across hospitals.
View Article and Find Full Text PDFJohn Marshall J Comput Inf Law
October 2000