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Becker BF, Kors JA, van Mulligen EM, Sturkenboom MC. Alignment of vaccine codes using an ontology of vaccine descriptions. J Biomed Semantics 2022; 13:24. [PMID: 36258262 PMCID: PMC9580193 DOI: 10.1186/s13326-022-00278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaccine information in European electronic health record (EHR) databases is represented using various clinical and database-specific coding systems and drug vocabularies. The lack of harmonization constitutes a challenge in reusing EHR data in collaborative benefit-risk studies about vaccines. METHODS We designed an ontology of the properties that are commonly used in vaccine descriptions, called Ontology of Vaccine Descriptions (VaccO), with a dictionary for the analysis of multilingual vaccine descriptions. We implemented five algorithms for the alignment of vaccine coding systems, i.e., the identification of corresponding codes from different coding ystems, based on an analysis of the code descriptors. The algorithms were evaluated by comparing their results with manually created alignments in two reference sets including clinical and database-specific coding systems with multilingual code descriptors. RESULTS The best-performing algorithm represented code descriptors as logical statements about entities in the VaccO ontology and used an ontology reasoner to infer common properties and identify corresponding vaccine codes. The evaluation demonstrated excellent performance of the approach (F-scores 0.91 and 0.96). CONCLUSION The VaccO ontology allows the identification, representation, and comparison of heterogeneous descriptions of vaccines. The automatic alignment of vaccine coding systems can accelerate the readiness of EHR databases in collaborative vaccine studies.
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Affiliation(s)
- Benedikt Fh Becker
- Department of Medical Informatics, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3015, GE, The Netherlands.
| | - Jan A Kors
- Department of Medical Informatics, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3015, GE, The Netherlands
| | - Erik M van Mulligen
- Department of Medical Informatics, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3015, GE, The Netherlands
| | - Miriam Cjm Sturkenboom
- Department of Medical Informatics, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam, 3015, GE, The Netherlands
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Duszynski KM, Stark JH, Cohet C, Huang WT, Shin JY, Lai ECC, Man KKC, Choi NK, Khromava A, Kimura T, Huang K, Watcharathanakij S, Kochhar S, Chen RT, Pratt NL. Suitability of databases in the Asia-Pacific for collaborative monitoring of vaccine safety. Pharmacoepidemiol Drug Saf 2021; 30:843-857. [PMID: 33634545 DOI: 10.1002/pds.5214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/22/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Information regarding availability of electronic healthcare databases in the Asia-Pacific region is critical for planning vaccine safety assessments particularly, as COVID-19 vaccines are introduced. This study aimed to identify data sources in the region, potentially suitable for vaccine safety surveillance. This manuscript is endorsed by the International Society for Pharmacoepidemiology (ISPE). METHODS Nineteen countries targeted for database reporting were identified using published country lists and review articles. Surveillance capacity was assessed using two surveys: a 9-item introductory survey and a 51-item full survey. Survey questions related to database characteristics, covariate and health outcome variables, vaccine exposure characteristics, access and governance, and dataset linkage capability. Other questions collated research/regulatory applications of the data and local publications detailing database use for research. RESULTS Eleven databases containing vaccine-specific information were identified across 8 countries. Databases were largely national in coverage (8/11, 73%), encompassed all ages (9/11, 82%) with population size from 1.4 to 52 million persons. Vaccine exposure information varied particularly for standardized vaccine codes (5/11, 46%), brand (7/11, 64%) and manufacturer (5/11, 46%). Outcome data were integrated with vaccine data in 6 (55%) databases and available via linkage in 5 (46%) databases. Data approval processes varied, impacting on timeliness of data access. CONCLUSIONS Variation in vaccine data availability, complexities in data access including, governance and data release approval procedures, together with requirement for data linkage for outcome information, all contribute to the challenges in building a distributed network for vaccine safety assessment in the Asia-Pacific and globally. Common data models (CDMs) may help expedite vaccine safety research across the region.
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Affiliation(s)
- Katherine M Duszynski
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - James H Stark
- Vaccine Medical, Scientific and Clinical Affairs, Pfizer Inc., New York, New York, USA
| | - Catherine Cohet
- Vaccines Clinical Research & Development, GlaxoSmithKline, Wavre, Belgium
| | - Wan-Ting Huang
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kenneth K C Man
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.,Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Nam-Kyong Choi
- Department of Health Convergence, Ewha Womans University, Seoul, South Korea
| | - Alena Khromava
- Epidemiology and Benefit Risk, Sanofi Pasteur Ltd., Toronto, Ontario, Canada
| | | | - Kui Huang
- Global Medical Epidemiology, Worldwide Medical and Safety, Pfizer Inc., New York, New York, United States of America
| | | | - Sonali Kochhar
- Global Healthcare Consulting, New Delhi, India.,Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Robert T Chen
- Brighton Collaboration, The Task Force for Global Health, Decatur, Georgia, USA
| | - Nicole L Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Age-specific vaccination coverage estimates for influenza, human papillomavirus and measles containing vaccines from seven population-based healthcare databases from four EU countries – The ADVANCE project. Vaccine 2020; 38:3243-3254. [DOI: 10.1016/j.vaccine.2020.02.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/20/2020] [Accepted: 02/28/2020] [Indexed: 11/18/2022]
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Sturkenboom M, Braeye T, van der Aa L, Danieli G, Dodd C, Duarte-Salles T, Emborg HD, Gheorghe M, Kahlert J, Gini R, Huerta-Alvarez C, Martín-Merino E, McGee C, de Lusignan S, Picelli G, Roberto G, Tramontan L, Villa M, Weibel D, Titievsky L. ADVANCE database characterisation and fit for purpose assessment for multi-country studies on the coverage, benefits and risks of pertussis vaccinations. Vaccine 2020; 38 Suppl 2:B8-B21. [PMID: 32061385 DOI: 10.1016/j.vaccine.2020.01.100] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 01/27/2020] [Accepted: 01/31/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The public-private ADVANCE consortium (Accelerated development of vaccine benefit-risk collaboration in Europe) aimed to assess if electronic healthcare databases can provide fit-for purpose data for collaborative, distributed studies and monitoring of vaccine coverage, benefits and risks of vaccines. OBJECTIVE To evaluate if European healthcare databases can be used to estimate vaccine coverage, benefit and/or risk using pertussis-containing vaccines as an example. METHODS Characterisation was conducted using open-source Java-based (Jerboa) software and R scripts. We obtained: (i) The general characteristics of the database and data source (meta-data) and (ii) a detailed description of the database population (size, representatively of age/sex of national population, rounding of birth dates, delay between birth and database entry), vaccinations (number of vaccine doses, recording of doses, pattern of doses by age and coverage) and events of interest (diagnosis codes, incidence rates). A total of nine databases (primary care, regional/national record linkage) provided data on events (pertussis, pneumonia, death, fever, convulsions, injection site reactions, hypotonic hypo-responsive episode, persistent crying) and vaccines (acellular pertussis and whole cell pertussis) related to the pertussis proof of concept studies. RESULTS The databases contained data for a total population of 44 million individuals. Seven databases had recorded doses of vaccines. The pertussis coverage estimates were similar to those reported by the World Health Organisation (WHO). Incidence rates of events were comparable in magnitude and age-distribution between databases with the same characteristics. Several conditions (persistent crying and somnolence) were not captured by the databases for which outcomes were restricted to hospital discharge diagnoses. CONCLUSION The database characterisation programs and workflows allowed for an efficient, transparent and standardised description and verification of electronic healthcare databases which may participate in pertussis vaccine coverage, benefit and risk studies. This approach is ready to be used for other vaccines/events to create readiness for participation in other vaccine related studies.
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Affiliation(s)
- Miriam Sturkenboom
- Julius Global Health, University Medical Center Utrecht, Heidelberglaan 100, the Netherlands; VACCINE.GRID, Basel, Switzerland VACCINE.GRID, Spitalstrasse 33, Basel, Switzerland; P-95, Leuven, Belgium Koning Leopold III laan, 1, 3001 Heverlee, Belgium.
| | - Toon Braeye
- Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Lieke van der Aa
- Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Giorgia Danieli
- Consorzio Arsenal.IT, Veneto Region, Italy; Epidemiological Information for Clinical Research from an Italian Network of Family Paediatricians (PEDIANET), Padova, Italy.
| | - Caitlin Dodd
- Julius Global Health, University Medical Center Utrecht, Heidelberglaan 100, the Netherlands; Erasmus University Medical Center, PO Box 2014, 3000 CA Rotterdam, the Netherlands.
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
| | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Artillerivej 5, DK-2300, Denmark.
| | - Marius Gheorghe
- Erasmus University Medical Center, PO Box 2014, 3000 CA Rotterdam, the Netherlands.
| | - Johnny Kahlert
- Aarhus University Hospital, Olof Palmes Alle 43-45, DK-8200 Aarhus, Denmark.
| | - Rosa Gini
- Agenzia regionale di sanità della Toscana, Osservatorio di epidemiologia, Florence, Italy.
| | | | | | - Chris McGee
- University of Surrey, Guildford, Surrey GU2 7XH, UK; Royal College of General Practitioners, Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK.
| | - Simon de Lusignan
- University of Surrey, Guildford, Surrey GU2 7XH, UK; Royal College of General Practitioners, Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK.
| | - Gino Picelli
- Epidemiological Information for Clinical Research from an Italian Network of Family Paediatricians (PEDIANET), Padova, Italy.
| | - Giuseppe Roberto
- Agenzia regionale di sanità della Toscana, Osservatorio di epidemiologia, Florence, Italy.
| | - Lara Tramontan
- Consorzio Arsenal.IT, Veneto Region, Italy; Epidemiological Information for Clinical Research from an Italian Network of Family Paediatricians (PEDIANET), Padova, Italy.
| | | | - Daniel Weibel
- VACCINE.GRID, Basel, Switzerland VACCINE.GRID, Spitalstrasse 33, Basel, Switzerland; Erasmus University Medical Center, PO Box 2014, 3000 CA Rotterdam, the Netherlands
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Sturkenboom M, Bahri P, Chiucchiuini A, Grove Krause T, Hahné S, Khromava A, Kokki M, Kramarz P, Kurz X, Larson HJ, de Lusignan S, Mahy P, Torcel-Pagnon L, Titievsky L, Bauchau V. Why we need more collaboration in Europe to enhance post-marketing surveillance of vaccines. Vaccine 2019; 38 Suppl 2:B1-B7. [PMID: 31677952 DOI: 10.1016/j.vaccine.2019.07.081] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 11/19/2022]
Abstract
The influenza A/H1N1 pandemic in 2009 taught us that the monitoring of vaccine benefits and risks in Europe had potential for improvement if different public and private stakeholders would collaborate better (public health institutes (PHIs), regulatory authorities, research institutes, vaccine manufacturers). The Innovative Medicines Initiative (IMI) subsequently issued a competitive call to establish a public-private partnership to build and test a novel system for monitoring vaccine benefits and risks in Europe. The ADVANCE project (Accelerated Development of Vaccine benefit-risk Collaboration in Europe) was created as a result. The objective of this paper is to describe the perspectives of key stakeholder groups of the ADVANCE consortium for vaccine benefit-risk monitoring and their views on how to build a European system addressing the needs and challenges of such monitoring. These perspectives and needs were assessed at the start of the ADVANCE project by the European Medicines Agency together with representatives of the main stakeholders in the field of vaccines within and outside the ADVANCE consortium (i.e. research institutes, public health institutes, medicines regulatory authorities, vaccine manufacturers, patient associations). Although all stakeholder representatives stated they conduct vaccine benefit-risk monitoring according to their own remit, needs and obligations, they are faced with similar challenges and needs for improved collaboration. A robust, rapid system yielding high-quality information on the benefits and risks of vaccines would therefore support their decision making. ADVANCE has developed such a system and has tested its performance in a series of proof of concept (POC) studies. The system, how it was used and the results from the POC studies are described in the papers in this supplementary issue.
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Affiliation(s)
- Miriam Sturkenboom
- Julius Global Health, University Medical Center Utrecht, Heidelberglaan 100, the Netherlands; VACCINE.GRID, Spitalstrasse 33, Basel, Switzerland; P-95, Koning Leopold III laan 1, 3001 Heverlee, Belgium.
| | - Priya Bahri
- European Medicines Agency, 30 Churchill Pl, Canary Wharf, London E14 5EU, UK.
| | - Antonella Chiucchiuini
- Takeda Pharmaceuticals International GmbH, Thurgauerstrasse 130, 8152 Glattpark, Switzerland.
| | - Tyra Grove Krause
- Department of Infectious Disease, Epidemiology and Prevention, Statens Serum Institut, Artillerivej 3, DK-2100, Denmark.
| | - Susan Hahné
- National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, the Netherlands.
| | - Alena Khromava
- Sanofi Pasteur, 1755 Steeles Ave W, North York, ON M2R 3T4, Canada.
| | - Maarit Kokki
- European Center for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Piotr Kramarz
- European Center for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Xavier Kurz
- European Medicines Agency, 30 Churchill Pl, Canary Wharf, London E14 5EU, UK.
| | - Heidi J Larson
- London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK.
| | - Simon de Lusignan
- University of Surrey, Guildford, Surrey GU2 7XH, UK; Royal College of General Practitioners, 30 Euston Square, London NW1 2FB, UK.
| | - Patrick Mahy
- Sciensano, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
| | - Laurence Torcel-Pagnon
- Vaccine Epidemiology and Modelling (VEM), Sanofi Pasteur, Campus SANOFI LYON, 14 Espace Henry Vallée, 69007 Lyon, France.
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Torcel-Pagnon L, Bauchau V, Mahy P, Tin Tin Htar M, van der Sande M, Mahé C, Krause TG, Charrat A, Simondon F, Kurz X. Guidance for the governance of public-private collaborations in vaccine post-marketing settings in Europe. Vaccine 2019; 37:3278-3289. [DOI: 10.1016/j.vaccine.2019.04.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022]
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