Great Plains IDeA-Clinical and Translational Research Network, Urgent Competitive Revisions to IDeA and NARCH Programs for SARS-CoV-2 Surveillance Studies

项目摘要： 大平原IDEA临床和转化研究（GP IDEA-CTR） 网络响应NIGMS关于对IDEA计划进行紧急竞争修订的电话（NOT-GM-22-026）， SARS-CoV-2监测研究。我们的创新方法实现了三个具体目标（SA）：SA 1 UNMC SPHERES（CDC SARS-CoV-2测序用于公共卫生应急响应，流行病学， 和监督）团队，内布拉斯加州医学（NM）临床企业和内布拉斯加州公共卫生 实验室（NPHL），开发、标准化、验证和部署基础设施和通信 用于在起重机（临床研究分析环境）中集成实时病毒变种数据的协议。 起重机是从NM EHR系统中提取的研究数据仓库，包含超过140万个 个人，包括29，000名SARS-CoV-2感染者和2，000名具有变异数据的人， 直接联系。SA 2创建了一个联盟，在内布拉斯加州组织COVID 19（CORN-19）研究， 跨越公共卫生专家，临床科学家和信息学家，加强发现管道 从长凳到床边再到政策。SA 3内布拉斯加州SARS-CoV-2变异株地理分布概况 区域、风险概况和健康的社会决定因素。 该项目部署、利用、整合并受益于联合国军事委员会的若干强大能力。 新墨西哥大学拥有美国最具成效的传染病部门之一，与州和国家密切相关 监控网络;是CDC的SPHERES项目的一个站点;拥有美国最大的生物防护单位; 提供SARS-CoV-2全基因组测序支持，并在NE范围内进行变异追踪， NPHL;并维护起重机数据仓库。我们部署这些强大的功能来测试 COVID-19疾病（急性和慢性）、疫苗接种后感染和社区之间的假设联系 与特定的SARS-CoV-2突变和谱系一致，符合五个NOT-GM-21-031优先事项 领域：1）人群中的变异体以及不同变异体引起的病例如何随时间变化？2)是 与暴发事件、地理位置或特定 时代？3)不同的变异如何在不同的种族、民族、性别或年龄组中分布？4)是 与不同COVID-19症状相关的特定变体？5)特定的变异是否与更多的 疫苗频频突破与EHR数据相关联的实时健康监测数据扩大了这种可能性 一个学习型医疗保健系统，在这个系统中，可采取行动的证据可以改善医疗保健，挽救我们所有人的生命。 社区，特别是在医疗服务不足和农村地区。由于这种一体化的筒仓- 跨越项目，我们希望提供一个强大的，可扩展的，平等的框架，为社区参与 CTR -一个解决紧急生物医学研究需求的国家模式，其持续时间超过目前的流行病 并承诺为未来的学术-公共-私营合作伙伴关系提供跳板，以更好地为我们的地区服务。

Project Summary: This application from the Great Plains IDeA Clinical and Translational Research (GP IDeA-CTR) network responds to NIGMS call (NOT-GM-22-026) for Urgent Competitive Revisions to IDeA Programs for SARS-CoV-2 Surveillance Studies. Our innovative approach addresses three specific aims (SA): SA1 Unites the UNMC SPHERES (CDC SARS-CoV-2 Sequencing for Public Health Emergency Response, Epidemiology, and Surveillance) team, Nebraska Medicine (NM) clinical enterprise, and the Nebraska Public Health Laboratory (NPHL), to develop, standardize, validate, and deploy the infrastructure and communication protocols for integrating real-time viral variant data within CRANE (Clinical Research Analytics Environment). CRANE is a research data warehouse extracted from the NM EHR system, comprising over 1.4 million individuals, including 29,000 SARS-CoV-2 infected persons and 2,000 with variant data available for immediate linkage. SA2 Creates a Consortium to Organize Research in Nebraska for Covid 19 (CORN-19), spanning public health experts, clinician-scientists, and informaticists, strengthening the discovery pipeline from bench to bedside to policy. SA3 Profile the SARS-CoV-2 variant landscape in Nebraska by geographic region, risk profiles, and social determinants of health. This project deploys, leverages, integrates, and benefits from several powerful UNMC capabilities. UNMC hosts one of the most productive US infectious disease units, closely linked with state and national surveillance networks; is a site in the CDC’s SPHERES program; holds the largest US biocontainment unit; provides SARS-CoV-2 whole-genome sequencing support and variant tracking across NE with strong ties to the NPHL; and maintains the CRANE data warehouse. We deploy these powerful capabilities to test hypothetical links between COVID-19 illness (acute and chronic), post-vaccination infection, and community susceptibly with specific SARS-CoV-2 mutations and lineages, in line with five NOT-GM-21-031 priorities areas: 1) Variants in the population and how cases caused by different variants change over time? 2) Are cases of infection by different variants associated with outbreak events, geographic locations, or specific times? 3) How are different variants distributed among different racial, ethnical, gender, or age groups? 4) Are specific variants associated with different COVID-19 symptoms? 5) Are specific variants associated with more frequent vaccine breakthroughs. Real-time health surveillance data linked to EHR data expands the possibility of a learning healthcare system in which actionable evidence improves health care and saves lives across our communities, particularly in medically underserved and rural areas. As a result of this integrative silo- spanning project, we expect to provide a robust, scalable, egalitarian framework for community-engaged CTR – a national model for addressing urgent biomedical research needs that outlasts the current pandemic and promises a springboard toward future academic-public-private partnerships to serve our region better.