External phenome analysis enables a rational federated query strategy to detect changing rates of treatment-related complications associated with multiple myeloma.
External phenome analysis enables a rational federated query strategy to detect changing rates of treatment-related complications associated with multiple myeloma.
复制标题
外部表组分析使合理的联合查询策略能够检测与多发性骨髓瘤相关的治疗相关并发症的变化率。
DOI：
10.1136/amiajnl-2012-001355
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Joyce,RobinM
中科院分区：
文献类型：
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作者：
Warner,JeremyL;Alterovitz,Gil;Bodio,Kelly;Joyce,RobinM
电子健康记录（EHR）对卫生服务研究越来越有用。对于相对不常见的疾病，如多发性骨髓瘤（MM）及其治疗相关并发症，多个EHR来源的组合对于此类研究至关重要。共享健康研究信息网络（SHRINE）可以查询参与机构的汇总结果。通过分析已有的数据库，可以增强SHRINE中合理检索策略的制定。我们根据重症监护多参数智能监测（MIMIC II）数据库的分析，开发了一种SHRINE查询MM可能的非感染性治疗相关并发症。使用这种查询策略，我们发现，从2001年到2007年，在参与SHRINE的机构中，可能与治疗相关的并发症的发生率显著增加，平均每年增加6%（p=0.01）。这一发现与MM治疗中越来越积极的策略保持一致。这一概念证明表明，使用外部EHR数据进行联合查询的分阶段方法可以产生潜在的临床有意义的结果。
Electronic health records (EHRs) are increasingly useful for health services research. For relatively uncommon conditions, such as multiple myeloma (MM) and its treatment-related complications, a combination of multiple EHR sources is essential for such research. The Shared Health Research Information Network (SHRINE) enables queries for aggregate results across participating institutions. Development of a rational search strategy in SHRINE may be augmented through analysis of pre-existing databases. We developed a SHRINE query for likely non-infectious treatment-related complications of MM, based upon an analysis of the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC II) database. Using this query strategy, we found that the rate of likely treatment-related complications significantly increased from 2001 to 2007, by an average of 6% a year (p=0.01), across the participating SHRINE institutions. This finding is in keeping with increasingly aggressive strategies in the treatment of MM. This proof of concept demonstrates that a staged approach to federated queries, using external EHR data, can yield potentially clinically meaningful results.