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Row 1: J Meller, J Dexheimer, A Jegga
Row 2: J Ma, J Hutton, K Marsolo, M Kouril, E Hall
Row 3: M Wagner, A Spooner
The data warehousing group, headed by Keith Marsolo, PhD, has continued its work to add more data from the enterprise Epic electronic health record (EHR) into the de-identified i2b2 warehouse and continues to provide investigators with more than 100 research datasets each year. The i2b2 group is participating in a national demonstration project to create a federated network of data warehouses from seven academic health centers (including the five Harvard teaching hospitals) using the Shared Health Research Information Network (SHRINE). The aims of this project are to prove the feasibility of creating such data sharing networks and to examine co-morbidities in patients with diabetes mellitus II or autism spectrum disorder. The warehouse group also has been active in supporting the institution’s efforts to create a research biorepository. They successfully deployed an application that allows biorepository staff to scan a clinical sample and determine whether it can be reused for research purposes. They are working to interface biosample processing instruments with the institutional biorepository and to interface the biorepository with the i2b2 data warehouse, allowing investigators to include sample criteria in their cohort search. Work in the coming year will enable investigators to send a request for samples to the biorepository using the i2b2 interface.
The software development group continues to provide investigators with web-based tools to support research studies, learning networks and other collaborations. The group has developed the data infrastructure used by the three multi-center quality improvement networks supported by the Ohio Best Evidence for Advancing Child health in Ohio Now (BEACON). These groups are focused in improving outcomes in childhood obesity, children’s mental health and in reducing preterm births in Ohio. They are developing patient-facing registries for patients with eosinophilic esophagitis or a bone marrow transplant and research registries for the intestinal rehab team. The software development group is developing the data collection and reporting infrastructure for the nationwide Solutions for Patient Safety collaborative and is working with investigators in pharmacology and kidney transplant to create a “drug dashboard” that will pull together adherence data (from electronic pill bottles), clinical data and pharmacogenomics information and provide care recommendations, allowing investigators to perform pre-clinic planning.
In collaboration with ImproveCareNow, a 37-center network of gastroenterologists that provide care to children with inflammatory bowel disease, the Division of Biomedical Informatics (BMI) is finishing the second year of a 3-year, $12 million grant from AHRQ that aims to create distributed registry that can be populated with data directly from electronic health records (EHR) to support comparative effectiveness and quality improvement research. The registry is built on the open-source SHRINE and i2b2 platforms and will allow users to upload data that was captured in the EHR, removing the need for staff to perform double data entry. Developers in BMI are creating quality and population reports on top of the registry that will allow users to generate them on demand. Also included will be pre-visit planning reports and “status reports” that will be sent directly to patients to provide them with a view of their registry record and questions they may ask their clinician during their next visit. The team is also working to make the registry geographically distributed, making it possible for sites to keep their registry data at their own institution, but still share aggregate numbers across institutions for reporting purposes. The registry data is also being used to compare the effectiveness of alternative treatment strategies for pediatric inflammatory disease patients, with a special focus on the timing of biologic agents. The aim is to improve outcomes of treatment of children with this disease.
Dr. Imre Solti is building a clinical Natural Language Processing (NLP) infrastructure at CCHMC. The NLP pipeline is based on the Mayo-Harvard developed and i2b2-integrated open source clinical Text Analysis and Knowledge Extraction System (cTAKES). The ultimate goal of this project is to facilitate the extraction of clinically relevant information from narrative notes of the electronic health record for patient safety, health care quality improvement, and clinical research purposes. The early version of the NLP pipeline is already deployed in the most recent NIH funded eMERGE (PI Harley) and clinical trial eligibility screening automation (PI Solti) and internal Place Outcome Award grants.
In his collaborations with Dr. Nichols, Dr. Aronow provides complete interaction and direction for the interpretation of resulting data, including statistically and biologically significant gene expression patterns associated with hypoxia and improved right ventricular function in chronic lung disease in the context of all available information that pertains to understanding of normal, disease and developmental pathway and the gene network based processes. He is also fully involved in the prediction and analysis of strain variant gene polymorphisms that appear to play modifier roles.
Dr. Marsolo and his team are collaborating with Dr. Nichols to create a national biological sample and data repository for Pulmonary Arterial Hypertension. This work involves the creation of a biobank to house the biospecimens, and the creation of a PAH-specific i2b2 warehouse that will allow external users to search for cohorts based on clinical or sample-related criteria and request the corresponding samples for the biobank.
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