Developing a shared sepsis data infrastructure: a systematic review and concept map to FHIR.
Developing a shared sepsis data infrastructure: a systematic review and concept map to FHIR.
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DOI：
10.1038/s41746-022-00580-2
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发表时间：
2022-04-04
影响因子：
15.2
通讯作者：
Liu VX
中科院分区：
文献类型：
--
作者：
Brant EB;Kennedy JN;King AJ;Gerstley LD;Mishra P;Schlessinger D;Shalaby J;Escobar GJ;Angus DC;Seymour CW;Liu VX
在卫生系统之间开发共享数据基础设施可以改善包括败血症在内的一系列疾病的研究，临床护理和卫生政策。COVID-19提高了人们对此类基础设施潜在价值的认识，因为缺乏实时、可互操作的数据网络削弱了疾病的识别、缓解和根除。FHIR上的脓毒症合作建立了一个动态的、联合的、可互操作的脓毒症数据系统，来自55家医院，使用2个不同的住院电子健康记录系统。在这里，我们报告了第1阶段，一项系统性综述，以确定定义脓毒症及其亚型所需的临床变量，从而将元素概念映射到快速医疗互操作性资源（FHIR）上。相关论文描述了脓毒症的共识定义，提供了脓毒症、严重脓毒症、脓毒性休克或详细脓毒症亚型的标准。前瞻性排除了非英文撰写、1970年之前发表的研究或“灰色”文献。我们分析了55份手稿，产生151个独特的临床变量。然后，我们将变量映射到相应的US Core FHIR资源和特定代码值。这项工作建立了一个框架，以开发一个灵活的基础设施，用于共享脓毒症数据，强调FHIR如何能够将这种方法扩展到与公共卫生相关的其他重要条件。
The development of a shared data infrastructure across health systems could improve research, clinical care, and health policy across a spectrum of diseases, including sepsis. Awareness of the potential value of such infrastructure has been heightened by COVID-19, as the lack of a real-time, interoperable data network impaired disease identification, mitigation, and eradication. The Sepsis on FHIR collaboration establishes a dynamic, federated, and interoperable system of sepsis data from 55 hospitals using 2 distinct inpatient electronic health record systems. Here we report on phase 1, a systematic review to identify clinical variables required to define sepsis and its subtypes to produce a concept mapping of elements onto Fast Healthcare Interoperability Resources (FHIR). Relevant papers described consensus sepsis definitions, provided criteria for sepsis, severe sepsis, septic shock, or detailed sepsis subtypes. Studies not written in English, published prior to 1970, or “grey” literature were prospectively excluded. We analyzed 55 manuscripts yielding 151 unique clinical variables. We then mapped variables to their corresponding US Core FHIR resources and specific code values. This work establishes the framework to develop a flexible infrastructure for sharing sepsis data, highlighting how FHIR could enable the extension of this approach to other important conditions relevant to public health.
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