1
|
Delfin C, Dragan I, Kuznetsov D, Tajes JF, Smit F, Coral DE, Farzaneh A, Haugg A, Hungele A, Niknejad A, Hall C, Jacobs D, Marek D, Fraser DP, Thuillier D, Ahmadizar F, Mehl F, Pattou F, Burdet F, Hawkes G, Arts ICW, Blanch J, Van Soest J, Fernández-Real JM, Boehl J, Fink K, van Greevenbroek MMJ, Kavousi M, Minten M, Prinz N, Ipsen N, Franks PW, Ramos R, Holl RW, Horban S, Duarte-Salles T, Tran VDT, Raverdy V, Leal Y, Lenart A, Pearson E, Sparsø T, Giordano GN, Ioannidis V, Soh K, Frayling TM, Le Roux CW, Ibberson M. A Federated Database for Obesity Research: An IMI-SOPHIA Study. Life (Basel) 2024; 14:262. [PMID: 38398771 PMCID: PMC10890572 DOI: 10.3390/life14020262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Obesity is considered by many as a lifestyle choice rather than a chronic progressive disease. The Innovative Medicines Initiative (IMI) SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) project is part of a momentum shift aiming to provide better tools for the stratification of people with obesity according to disease risk and treatment response. One of the challenges to achieving these goals is that many clinical cohorts are siloed, limiting the potential of combined data for biomarker discovery. In SOPHIA, we have addressed this challenge by setting up a federated database building on open-source DataSHIELD technology. The database currently federates 16 cohorts that are accessible via a central gateway. The database is multi-modal, including research studies, clinical trials, and routine health data, and is accessed using the R statistical programming environment where statistical and machine learning analyses can be performed at a distance without any disclosure of patient-level data. We demonstrate the use of the database by providing a proof-of-concept analysis, performing a federated linear model of BMI and systolic blood pressure, pooling all data from 16 studies virtually without any analyst seeing individual patient-level data. This analysis provided similar point estimates compared to a meta-analysis of the 16 individual studies. Our approach provides a benchmark for reproducible, safe federated analyses across multiple study types provided by multiple stakeholders.
Collapse
Affiliation(s)
| | - Iulian Dragan
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Dmitry Kuznetsov
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Juan Fernandez Tajes
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Clinical Research Centre (CRC), Lund University, Jan Waldenströmsgata 35, SE-20502 Malmö, Sweden
| | - Femke Smit
- Maastricht Center for Systems Biology, Faculty of Science and Engineering, Maastricht University, Paul Henri Spaaklaan 1, 6229 EN Maastricht, The Netherlands
| | - Daniel E. Coral
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Clinical Research Centre (CRC), Lund University, Jan Waldenströmsgata 35, SE-20502 Malmö, Sweden
| | - Ali Farzaneh
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - André Haugg
- Global Biostatistics & Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88400 Biberach, Germany
| | - Andreas Hungele
- Institute of Epidemiology and Medical Biometry, CAQM, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Anne Niknejad
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Christopher Hall
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee DD1 4HN, UK
| | - Daan Jacobs
- Nederlandse Obesitas Kliniek, Huis Ter Heide, 3712 BA Utrecht, The Netherlands
| | - Diana Marek
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Diane P. Fraser
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK
| | - Dorothee Thuillier
- Univ Lille, Inserm, CHU Lille, Pasteur Institute Lille, U1190 Translational Research for Diabetes, European Genomic Institute of Diabetes, 59000 Lille, France; (D.T.)
| | - Fariba Ahmadizar
- Data Science and Biostatistics Department, Julius Global Health, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Florence Mehl
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Francois Pattou
- Univ Lille, Inserm, CHU Lille, Pasteur Institute Lille, U1190 Translational Research for Diabetes, European Genomic Institute of Diabetes, 59000 Lille, France; (D.T.)
| | - Frederic Burdet
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Gareth Hawkes
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK
| | - Ilja C. W. Arts
- Maastricht Center for Systems Biology, Faculty of Science and Engineering, Maastricht University, Paul Henri Spaaklaan 1, 6229 EN Maastricht, The Netherlands
| | - Jordi Blanch
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- ISV-Girona Research Group, Research Unit in Primary Care, Primary Care Services, Catalan Institute of Health (ICS), 08908 Barcelona, Spain
| | - Johan Van Soest
- Brightlands Institute for Smart Society (BISS), Faculty of Science and Engineering, Maastricht University, 6229 EN Maastricht, The Netherlands
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Center, 6229 EN Maastricht, The Netherlands
| | - José-Manuel Fernández-Real
- Nutrition, Eumetabolism and Health Group, Institut d’Investigació Biomèdica de Girona (IDIBGI-CERCA), Av. França 30, 17007 Girona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, 17003 Girona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Av. França, s/n, 17007 Girona, Spain
| | - Juergen Boehl
- Global Biostatistics & Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88400 Biberach, Germany
| | - Katharina Fink
- Institute of Epidemiology and Medical Biometry, CAQM, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Marleen M. J. van Greevenbroek
- Department of Internal Medicine and CARIM School of Cardiovascular Diseases, Maastricht University, 6229 EN Maastricht, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Michiel Minten
- Maastricht Center for Systems Biology, Faculty of Science and Engineering, Maastricht University, Paul Henri Spaaklaan 1, 6229 EN Maastricht, The Netherlands
| | - Nicole Prinz
- Institute of Epidemiology and Medical Biometry, CAQM, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | | | - Paul W. Franks
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Clinical Research Centre (CRC), Lund University, Jan Waldenströmsgata 35, SE-20502 Malmö, Sweden
| | - Rafael Ramos
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, 17003 Girona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Research in Vascular Health Group, Institut d’Investigació Biomèdica de Girona (IDIBGI-CERCA), Parc Hospitalari Martí i Julià, Edifici M2, 17190 Salt, Spain
| | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, CAQM, University of Ulm, 89081 Ulm, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Scott Horban
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee DD1 4HN, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Van Du T. Tran
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Violeta Raverdy
- Univ Lille, Inserm, CHU Lille, Pasteur Institute Lille, U1190 Translational Research for Diabetes, European Genomic Institute of Diabetes, 59000 Lille, France; (D.T.)
| | - Yenny Leal
- Nutrition, Eumetabolism and Health Group, Institut d’Investigació Biomèdica de Girona (IDIBGI-CERCA), Av. França 30, 17007 Girona, Spain
- Department of Medical Sciences, School of Medicine, University of Girona, 17003 Girona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Diabetes, Endocrinology and Nutrition, Dr. Josep Trueta University Hospital, Av. França, s/n, 17007 Girona, Spain
| | | | - Ewan Pearson
- Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee DD1 4HN, UK
| | | | - Giuseppe N. Giordano
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Clinical Research Centre (CRC), Lund University, Jan Waldenströmsgata 35, SE-20502 Malmö, Sweden
| | - Vassilios Ioannidis
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| | - Keng Soh
- Novo Nordisk A/S, 2860 Søborg, Denmark
| | - Timothy M. Frayling
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, 1 Rue Michel-Servet, CH-1211 Geneva, Switzerland
| | - Carel W. Le Roux
- Diabetes Complications Research Centre, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Mark Ibberson
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, CH-1015 Lausanne, Switzerland
| |
Collapse
|
2
|
Hartmann-Boyce J, Highton P, Rees K, Onakpoya I, Suklan J, Curtis F, O'Mahoney L, Morris E, Kudlek L, Morgan J, Lynch R, Marpadga S, Seidu S, Khunti K. The impact of the COVID-19 pandemic and associated disruptions in health-care provision on clinical outcomes in people with diabetes: a systematic review. Lancet Diabetes Endocrinol 2024; 12:132-148. [PMID: 38272607 DOI: 10.1016/s2213-8587(23)00351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
The COVID-19 pandemic triggered disruptions to health care and lifestyles that could conceivably impact diabetes management. We set out to identify the impact of disruptions caused by COVID-19 on clinical outcomes in people with diabetes. We performed a systematic review of the available literature in the MEDLINE and OVID databases from Jan 1, 2020, to June 7, 2023, and included 138 studies (n>1 000 000 people). All but five studies were judged to be at some risk of bias. All studies compared prepandemic with pandemic periods. All-cause mortality (six studies) and diabetes-related mortality (13 studies) showed consistent increases, and most studies indicated increases in sight loss (six studies). In adult and mixed samples, data generally suggested no difference in diabetic ketoacidosis frequency or severity, whereas in children and adolescents most studies showed increases with some due to new-onset diabetes (69 studies). Data suggested decreases in hospital admissions in adults but increases in diabetes-related admissions to paediatric intensive care units (35 studies). Data were equivocal on diabetic foot ulcer presentations (nine studies), emergency department admissions (nine studies), and overall amputation rates (20 studies). No studies investigated renal failure. Where reported, the impact was most pronounced for females, younger people, and racial and ethnic minority groups. Further studies are needed to investigate the longer-term impact of the pandemic and the on potential differential impacts, which risk further exacerbating existing inequalities within people with diabetes.
Collapse
Affiliation(s)
- Jamie Hartmann-Boyce
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | | | | | - Igho Onakpoya
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Jana Suklan
- National Institute for Health and Care Research Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle, UK
| | - Ffion Curtis
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | | | - Elizabeth Morris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Kudlek
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jessica Morgan
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Rosie Lynch
- Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Samuel Seidu
- Diabetes Research Centre, University of Leicester, UK
| | | |
Collapse
|
3
|
Framme JR, Kim-Dorner SJ, Heidtmann B, Kapellen TM, Lange K, Kordonouri O, Saßmann H. Health-related quality of life among adolescents with type 1 diabetes since the second wave of the COVID-19 pandemic in Germany. Fam Med Community Health 2023; 11:e002415. [PMID: 37967993 PMCID: PMC10660822 DOI: 10.1136/fmch-2023-002415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic had an impact on everyday life and in general, reduced the health-related quality of life (HRQoL) of adolescents. In this study, we assess the HRQoL of adolescents with type 1 diabetes (T1D) in Germany since the second wave of the COVID-19 pandemic by using self-report and parent-proxy reports, to identify risk factors, to compare to peers and to examine the agreement of HRQoL between parents and their children. METHODS A total of 445 adolescents (12-18 years) and 413 parents participated in an anonymous cross-sectional survey conducted at three German diabetes centres from January 2021 to June 2022. Inclusion criteria were diabetes duration ≥1 year and German-speaking. Teen HRQoL was assessed by using self-report and parent-proxy report versions of the KIDSCREEN-10 index. RESULTS The majority of adolescents reported average (75.5%) HRQoL. Approximately 11.3% of teens reported high and 13.2% low HRQoL. Teen's female gender, older age, higher diabetes burden and parental depression symptoms contributed to lower self-reported HRQoL among teens. For parent-proxy reports, increasing diabetes burdens, parental depression symptoms, non-migrant status, high education and ketoacidosis contributed to lower scores on teen HRQoL. The mean scores of the KIDSCREEN-10 index for adolescents did not differ from the German norm. In comparison to healthy peers during the first wave of the pandemic, adolescents in the current study reported higher HRQoL. The overall teen-parent agreement was fair although parents reported significantly lower teen HRQoL than adolescents did. CONCLUSIONS HRQoL of most adolescents with T1D during the COVID-19 pandemic was average with parents reporting significantly lower scores. Self-reported and parent-proxy-reported HRQoL and the level of agreement due to different perspectives can provide important information for clinical care and intervention planning.
Collapse
Affiliation(s)
| | | | - Bettina Heidtmann
- Paediatric Endocrinology and Diabetology, Catholic Childrens Hospital Wilhelmstift, Hamburg, Germany
| | - Thomas Michael Kapellen
- Hospital for Children and Adolescents, University of Leipzig Medical Center, Leipzig, Germany
- Department of Paediatrics, MEDIAN Children's Hospital "Am Nicolausholz", Bad Kösen, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Olga Kordonouri
- Diabetes Center for Children and Adolescents, Auf der Bult Children's Hospital, Hannover, Germany
| | - Heike Saßmann
- Medical Psychology, Hannover Medical School, Hannover, Germany
| |
Collapse
|