1
|
Foucher J, Azizi L, Öijerstedt L, Kläppe U, Ingre C. The usage of population and disease registries as pre-screening tools for clinical trials, a systematic review. Syst Rev 2024; 13:111. [PMID: 38654383 PMCID: PMC11040983 DOI: 10.1186/s13643-024-02533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE This systematic review aims to outline the use of population and disease registries for clinical trial pre-screening. MATERIALS AND METHODS The search was conducted in the time period of January 2014 to December 2022 in three databases: MEDLINE, Embase, and Web of Science Core Collection. References were screened using the Rayyan software, firstly based on titles and abstracts only, and secondly through full text review. Quality of the included studies was assessed using the List of Included Studies and quality Assurance in Review tool, enabling inclusion of publications of only moderate to high quality. RESULTS The search originally identified 1430 citations, but only 24 studies were included, reporting the use of population and/or disease registries for trial pre-screening. Nine disease domains were represented, with 54% of studies using registries based in the USA, and 62.5% of the studies using national registries. Half of the studies reported usage for drug trials, and over 478,679 patients were identified through registries in this review. Main advantages of the pre-screening methodology were reduced financial burden and time reduction. DISCUSSION AND CONCLUSION The use of registries for trial pre-screening increases reproducibility of the pre-screening process across trials and sites, allowing for implementation and improvement of a quality assurance process. Pre-screening strategies seem under-reported, and we encourage more trials to use and describe their pre-screening processes, as there is a need for standardized methodological guidelines.
Collapse
Affiliation(s)
- Juliette Foucher
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
| | - Louisa Azizi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linn Öijerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Ulf Kläppe
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Caroline Ingre
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
2
|
Ng SMS, Low R, Hoskin AK, Rousselot A, Gunasekeran DV, Natarajan S, Sundar G, Chee CKL, Mishra C, Sen P, Pradhan E, Irawati Y, Kamalden TA, Shah M, Yan H, Woreta FA, Subramanian PS, Kuhn F, Watson SL, Agrawal R. The application of clinical registries in ophthalmic trauma-the International Globe and Adnexal Trauma Epidemiology Study (IGATES). Graefes Arch Clin Exp Ophthalmol 2021; 260:1055-1067. [PMID: 34812939 DOI: 10.1007/s00417-021-05493-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/19/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022] Open
Abstract
Ophthalmic trauma is a leading cause of preventable monocular blindness worldwide. The prevalence of ophthalmic trauma varies considerably based on geographic location, socio-economic status, age groups, occupation, and cultural practices such as firework celebrations. Clinical registries are known to be valuable in guiding the diagnosis, management, and prognostication of complex diseases. However, there is currently a lack of a centralized international data repository for ophthalmic trauma. We draw lessons from past and existing clinical registries related to ophthalmology and propose a new suitable international multicenter clinical registry for ophthalmic trauma: the International Globe and Adnexal Trauma Epidemiology Study (IGATES). IGATES is hosted on a secure web-based platform which exhibits user-friendly smart features, an integrated Ocular Trauma Score (OTS) prognosis calculator, efficient data collection points, and schematic graphical software. IGATES currently has 37 participating centers globally. The data collected through IGATES will be primarily used to develop a more robust and improved ophthalmic trauma prognostic classification system, the Ocular Trauma Score-2 (OTS-2), which builds on previous systems such as the Birmingham Eye Trauma Terminology System (BETTS) and Ocular Trauma Score (OTS). Furthermore, IGATES will act as a springboard for further research into the epidemiology, diagnosis, and management of ophthalmic trauma. Ultimately, IGATES serves to advance the field of ophthalmic trauma and improve the care that patients with ophthalmic trauma receive.
Collapse
Affiliation(s)
| | - Rebecca Low
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore
| | - Annette K Hoskin
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Andres Rousselot
- Consultorios Oftalmológicos Benisek Ascarza, Capital Federal, Argentina
| | | | | | - Gangadhara Sundar
- National University Hospital, National University of Singapore, Singapore, Singapore
| | - Caroline Ka Lin Chee
- National University Hospital, National University of Singapore, Singapore, Singapore
| | | | | | - Eli Pradhan
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | | | | | - Mehul Shah
- Drashti Netralaya Eye Hospital, Dahod, India
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA
| | | | - Ferenc Kuhn
- Helen Keller Foundation for Research and Education, Birmingham, USA
- Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary
| | - Stephanie L Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Singapore, Singapore.
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Novena, 308433, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology & Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.
| |
Collapse
|
3
|
Mikita JS, Mitchel J, Gatto NM, Laschinger J, Tcheng JE, Zeitler EP, Swern AS, Flick ED, Dowd C, Lystig T, Calvert SB. Determining the Suitability of Registries for Embedding Clinical Trials in the United States: A Project of the Clinical Trials Transformation Initiative. Ther Innov Regul Sci 2021; 55:6-18. [PMID: 32572772 PMCID: PMC7785536 DOI: 10.1007/s43441-020-00185-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Patient registries are organized systems that use observational methods to collect uniform data on specified outcomes in a population defined by a particular disease, condition, or exposure. Data collected in registries often coincide with data that could support clinical trials. Integrating clinical trials within registries to create registry-embedded clinical trials offers opportunities to reduce duplicative data collection, identify and recruit patients more efficiently, decrease time to database lock, accelerate time to regulatory decision-making, and reduce clinical trial costs. This article describes a project of the Clinical Trials Transformation Initiative (CTTI) intended to help clinical trials researchers determine when a registry could potentially serve as the platform for the conduct of a clinical trial. METHODS Through a review of registry-embedded clinical trials and commentaries, semi-structured interviews with experts, and a multi-stakeholder expert meeting, the project team addressed how to identify and describe essential registry characteristics, practices, and processes required to for conducting embedded clinical trials intended for regulatory submissions in the United States. RESULTS Recommendations, suggested practices, and decision trees that facilitate the assessment of whether a registry is suitable for embedding clinical trials were developed, as well as considerations for the design of new registries. Essential registry characteristics include relevancy, robustness, reliability, and assurance of patient protections. CONCLUSIONS The project identifies a clear role for registries in creating a sustainable and reusable infrastructure to conduct clinical trials. Adoption of these recommendations will facilitate the ability to perform high-quality and efficient prospective registry-based clinical trials.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Sara B Calvert
- Clinical Trials Transformation Initiative, 200 Morris St, Durham, NC, 27701, USA.
| |
Collapse
|
4
|
Kazemi-Arpanahi H, Moulaei K, Shanbehzadeh M. Design and development of a web-based registry for Coronavirus (COVID-19) disease. Med J Islam Repub Iran 2020; 34:68. [PMID: 32974234 PMCID: PMC7500427 DOI: 10.34171/mjiri.34.68] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background: The 2019 coronavirus (COVID-19) is a highly contagious disease associated with a high morbidity and mortality worldwide. The accumulation of data through a prospective clinical registry enables public health authorities to make informed decisions based on real evidence obtained from surveillance of COVID-19. This registry is also fundamental to providing robust infrastructure for future research surveys. The purpose of this study was to design a registry and its minimum data set (MDS), as a valid and reliable data source for reporting and benchmarking COVID-19. Methods: This cross sectional and descriptive study provides a template for the required MDS to be included in COVID-19 registry. This was done by an extensive literature review and 2 round Delphi survey to validate the content, which resulted in a web-based registry created by Visual Studio 2019 and a database designed by Structured Query Language (SQL). Results: The MDS of COVID-19 registry was categorized into the administrative part with 3 sections, including 30 data elements, and the clinical part with 4 sections, including 26 data elements. Furthermore, a web-based registry with modular and layered architecture was designed based on final data classes and elements. Conclusion: To the best of our knowledge, COVID-19 registry is the first designed instrument from information management perspectives in Iran and can become a homogenous and reliable infrastructure for collecting data on COVID-19. We hope this approach will facilitate epidemiological surveys and support policymakers to better plan for monitoring patients with COVID-19.
Collapse
Affiliation(s)
- Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan Faculty of Medical Sciences, Abadan, Iran
| | - Khadijeh Moulaei
- Department of Health Information Management, School of Health Management and Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| |
Collapse
|
5
|
Karanatsios B, Prang KH, Verbunt E, Yeung JM, Kelaher M, Gibbs P. Defining key design elements of registry-based randomised controlled trials: a scoping review. Trials 2020; 21:552. [PMID: 32571382 PMCID: PMC7310018 DOI: 10.1186/s13063-020-04459-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 05/26/2020] [Indexed: 01/09/2023] Open
Abstract
Background Traditional randomised controlled trials remain the gold standard for improving clinical care but they do have their limitations, including their associated high costs, high failure rate and limited external validity. An alternative methodology is the newly defined, prospective, registry-based randomised controlled trial (RRCT), where treatment and outcome data is collected in an existing registry. This scoping review explores the current literature regarding RRCTs to help identify the key design elements of RRCTs and the characteristics of clinical registries on which they are reliant on. Methods A scoping review methodology conducted in accordance with the Joanna Briggs Institute guidelines was performed. Four databases were searched for articles published from inception to June 2018: Medline; Embase; the Cumulative Index to Nursing and Allied Health Literature and; Scopus. The search strategy included MeSH and text words related to RRCT. Results We identified 2369 articles of which 75 were selected for full-text screening. Of these, only 17 articles satisfied our inclusion criteria. All studies were published between 1996 and 2017 and all were investigator-initiated. Study designs were mainly multi-site comparative/effectiveness studies incorporating the use of disease registries (n = 8), procedure registries (n = 8) and a health services registry (n = 1). The low cost, reduced administrative burden and enhanced external validity of RRCTs make them an attractive research methodology which can be used to address questions of public health importance. We identified that that there are variable definitions of what constituted a RRCT and that issues related to ethical conduct and data integrity, completeness, timeliness, validation and endpoint adjudication need to be carefully addressed. Conclusion RRCTs potentially have an important role to play in informing best clinical practice and health policy. There are a number of issues that need to be addressed to optimise the utility of this approach, including establishing universally accepted criteria for the definition of a RRCT.
Collapse
Affiliation(s)
- Bill Karanatsios
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia. .,Western Health Chronic Disease Alliance, Western Health, St Albans, VIC, Australia.
| | - Khic-Houy Prang
- Centre for Health Policy, The University of Melbourne, Parkville, VIC, Australia
| | - Ebony Verbunt
- Centre for Health Policy, The University of Melbourne, Parkville, VIC, Australia
| | - Justin M Yeung
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia.,Western Health Chronic Disease Alliance, Western Health, St Albans, VIC, Australia
| | - Margaret Kelaher
- Centre for Health Policy, The University of Melbourne, Parkville, VIC, Australia
| | - Peter Gibbs
- Systems Biology and Personalised Medicine Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Center, Parkville, VIC, Australia
| |
Collapse
|
6
|
Abstract
Globally, an estimated 350 million people are affected by a rare disease diagnosis. Knowledge limitations persist for the majority of rare conditions due to systemic and structural challenges in healthcare and research. Disease-specific patient populations are often small and geographically dispersed; funding support for research is restricted; and diagnostic delays are common due to disease complexities, limited medical training for practitioners, and evolving foundational knowledge related to disease characterization. Patient registries can be effective, convenient, and cost-efficient tools to support documentation of the natural history of a disease, centering patients as research partners in the process while uniting rare communities around a common initiative. Current global trends towards innovative and patient-centered healthcare are enabling patient registries to increasingly emerge as valuable tools for use within rare disease research and drug development. This article describes the value of and rationale for establishing rare disease patient registries and the considerations and challenges that stakeholders, such as researchers, industry, health care providers, and patient community organizations, may encounter.
Collapse
Affiliation(s)
- Vanessa Boulanger
- National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06810 USA
| | - Marissa Schlemmer
- National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06810 USA
| | - Suzanne Rossov
- National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06810 USA
| | - Allison Seebald
- National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06810 USA
| | - Pamela Gavin
- National Organization for Rare Disorders, 55 Kenosia Avenue, Danbury, CT 06810 USA
| |
Collapse
|
7
|
Affiliation(s)
- David S Liebeskind
- From the Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles (D.S.L.)
| | - Colin P Derdeyn
- Departments of Radiology and Neurology, University of Iowa Hospitals and Clinics (C.P.D.)
| | - Lawrence R Wechsler
- Department of Neurology, University of Pittsburgh Medical Center, PA (L.R.W.)
| | | |
Collapse
|
8
|
Tan JCK, Ferdi AC, Gillies MC, Watson SL. Clinical Registries in Ophthalmology. Ophthalmology 2018; 126:655-662. [PMID: 30572076 DOI: 10.1016/j.ophtha.2018.12.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/21/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
TOPIC Clinical registries in ophthalmology. CLINICAL RELEVANCE In recent years, advancements in digital technology and increasing use of electronic medical records in health systems have led to the dramatic growth in large clinical data sets. Clinical data registries are organized systems that collect data on patients diagnosed with a disease or condition or who undergo a certain procedure. METHODS A search of the PUBMED database was conducted in January 2018 for clinical registries in ophthalmology. RESULTS Ninety-seven clinical eye registries were found, with significant growth in numbers in the last 4 decades. The most common conditions captured were blindness or low vision, corneal transplantation, glaucoma, and cataract surgery. Most registries originate in the European region, North America, and Australia. Nine registries had multinational coverage, whereas 48 were national registries. As the numbers and scope of clinical registries have expanded, valuable observational data have been used to study real-world clinical outcomes in healthcare quality measurement and improvement and to develop new guidelines and standards. Pertinent areas of its use include studying treatments and outcomes in cataract surgery, corneal transplantation, and macular degeneration. CONCLUSIONS The use of clinical registries for quality improvement and research has grown significantly in the last few decades, and this trend will continue as information technology infrastructures develop.
Collapse
Affiliation(s)
- Jeremy C K Tan
- Save Sight Institute, University of Sydney, Sydney, Australia; Sydney Eye Hospital, Sydney, Australia.
| | | | - Mark C Gillies
- Save Sight Institute, University of Sydney, Sydney, Australia
| | - Stephanie L Watson
- Save Sight Institute, University of Sydney, Sydney, Australia; Sydney Eye Hospital, Sydney, Australia
| |
Collapse
|
9
|
Abstract
PURPOSE OF THE REVIEW The aim of review is to describe the essential role of study designs beyond RCTs in contemporary contest of HF patients giving perspectives on its evolving. The article concludes with concern about the support of observational studies for future randomized clinical trials. RECENT FINDINGS With the aging population and spectacular advance in cardiovascular therapy, the clinical syndrome comprising heart failure (HF) is increasingly in complexity of heterogeneity. It remains among the most challenging of clinical syndromes with a magnitude of proposed pathophysiological mechanisms involving the heart and the interplay with cardiac and non-cardiac comorbidities. In this epidemiological scenario, randomized clinical trials are suffering from growing failed treatment, so that a deeper understanding of heterogeneity represents a major unmet need. This field also is greatly in a more nuanced comprehension about the applicability in clinical practice of trials' results derived from well-selected HF population. Thus, we need to reflect on trials failures and the translation of previous trials in clinical practice in order to redirect the future trial intervention.
Collapse
|
10
|
Gasperoni F, Ieva F, Barbati G, Scagnetto A, Iorio A, Sinagra G, Di Lenarda A. Multi-state modelling of heart failure care path: A population-based investigation from Italy. PLoS One 2017; 12:e0179176. [PMID: 28591172 DOI: 10.1371/journal.pone.0179176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/24/2017] [Indexed: 11/19/2022] Open
Abstract
Background How different risk profiles of heart failure (HF) patients can influence multiple readmissions and outpatient management is largely unknown. We propose the application of two multi-state models in real world setting to jointly evaluate the impact of different risk factors on multiple hospital admissions, Integrated Home Care (IHC) activations, Intermediate Care Unit (ICU) admissions and death. Methods and findings The first model (model 1) concerns only hospitalizations as possible events and aims at detecting the determinants of repeated hospitalizations. The second model (model 2) considers both hospitalizations and ICU/IHC events and aims at evaluating which profiles are associated with transitions in intermediate care with respect to repeated hospitalizations or death. Both are characterized by transition specific covariates, adjusting for risk factors. We identified 4,904 patients (4,129 de novo and 775 worsening heart failure, WHF) hospitalized for HF from 2009 to 2014. 2,714 (55%) patients died. Advanced age and higher morbidity load increased the rate of dying and of being rehospitalized (model 1), decreased the rate of being discharged from hospital (models 1 and 2) and increased the rate of inactivation of IHC (model 2). WHF was an important risk factor associated with hospital readmission. Conclusion Multi-state models enable a better identification of two patterns of HF patients. Once adjusted for age and comorbidity load, the WHF condition identifies patients who are more likely to be readmitted to hospital, but does not represent an increasing risk factor for activating ICU/IHC. This highlights different ways to manage specific patients’ patterns of care. These results provide useful healthcare support to patients’ management in real world context. Our study suggests that the epidemiology of the considered clinical characteristics is more nuanced than traditionally presented through a single event.
Collapse
|
11
|
Ieva F, Jackson CH, Sharples LD. Multi-state modelling of repeated hospitalisation and death in patients with heart failure: The use of large administrative databases in clinical epidemiology. Stat Methods Med Res 2017; 26:1350-1372. [PMID: 25817136 PMCID: PMC4964935 DOI: 10.1177/0962280215578777] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In chronic diseases like heart failure (HF), the disease course and associated clinical event histories for the patient population vary widely. To improve understanding of the prognosis of patients and enable health care providers to assess and manage resources, we wish to jointly model disease progression, mortality and their relation with patient characteristics. We show how episodes of hospitalisation for disease-related events, obtained from administrative data, can be used as a surrogate for disease status. We propose flexible multi-state models for serial hospital admissions and death in HF patients, that are able to accommodate important features of disease progression, such as multiple ordered events and competing risks. Fully parametric and semi-parametric semi-Markov models are implemented using freely available software in R. The models were applied to a dataset from the administrative data bank of the Lombardia region in Northern Italy, which included 15,298 patients who had a first hospitalisation ending in 2006 and 4 years of follow-up thereafter. This provided estimates of the associations of age and gender with rates of hospital admission and length of stay in hospital, and estimates of the expected total time spent in hospital over five years. For example, older patients and men were readmitted more frequently, though the total time in hospital was roughly constant with age. We also discuss the relative merits of parametric and semi-parametric multi-state models, and model assessment and comparison.
Collapse
Affiliation(s)
- Francesca Ieva
- Department of Mathematics “Federigo Enriques”, Universit degli Studi di Milano, Milano, Italy
| | | | - Linda D. Sharples
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds (UK)
| |
Collapse
|
12
|
Grossetti F, Ieva F, Paganoni AM. A multi-state approach to patients affected by chronic heart failure: The value added by administrative data. Health Care Manag Sci 2018; 21:281-91. [DOI: 10.1007/s10729-017-9400-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 04/28/2017] [Indexed: 11/26/2022]
|
13
|
Hall M, Cenko E, Bueno H, Gale CP. Contemporary roles of registries in clinical cardiology: Insights from Western and Eastern European countries. Int J Cardiol 2016; 217:S13-5. [DOI: 10.1016/j.ijcard.2016.06.220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/25/2016] [Indexed: 11/22/2022]
|
14
|
Mazzali C, Paganoni AM, Ieva F, Masella C, Maistrello M, Agostoni O, Scalvini S, Frigerio M. Methodological issues on the use of administrative data in healthcare research: the case of heart failure hospitalizations in Lombardy region, 2000 to 2012. BMC Health Serv Res 2016; 16:234. [PMID: 27391599 PMCID: PMC4939041 DOI: 10.1186/s12913-016-1489-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Administrative data are increasingly used in healthcare research. However, in order to avoid biases, their use requires careful study planning. This paper describes the methodological principles and criteria used in a study on epidemiology, outcomes and process of care of patients hospitalized for heart failure (HF) in the largest Italian Region, from 2000 to 2012. METHODS Data were extracted from the administrative data warehouse of the healthcare system of Lombardy, Italy. Hospital discharge forms with HF-related diagnosis codes were the basis for identifying HF hospitalizations as clinical events, or episodes. In patients experiencing at least one HF event, hospitalizations for any cause, outpatient services utilization, and drug prescriptions were also analyzed. RESULTS Seven hundred one thousand, seven hundred one heart failure events involving 371,766 patients were recorded from 2000 to 2012. Once all the healthcare services provided to these patients after the first HF event had been joined together, the study database totalled about 91 million records. Principles, criteria and tips utilized in order to minimize errors and characterize some relevant subgroups are described. CONCLUSIONS The methodology of this study could represent the basis for future research and could be applied in similar studies concerning epidemiology, trend analysis, and healthcare resources utilization.
Collapse
Affiliation(s)
- Cristina Mazzali
- />Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Anna Maria Paganoni
- />MOX–Department of Mathematics, Politecnico di Milano, Via Bonardi 9, 20133 Milan, Italy
| | - Francesca Ieva
- />Department of Mathematics, Università degli Studi di Milano, Milan, Italy
| | - Cristina Masella
- />Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | | | | | | | - Maria Frigerio
- />De Gasperis Cardiocenter, Niguarda-Ca’Granda hospital, Milan, Italy
| | - On behalf of the HF Data Project
- />Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
- />MOX–Department of Mathematics, Politecnico di Milano, Via Bonardi 9, 20133 Milan, Italy
- />Department of Mathematics, Università degli Studi di Milano, Milan, Italy
- />Ospedale Uboldo, AO Melegnano, Milan, Italy
- />AO San Carlo di Milano, Milan, Italy
- />IRCCS Fondazione S. Maugeri di Lumezzane, Brescia, Italy
- />De Gasperis Cardiocenter, Niguarda-Ca’Granda hospital, Milan, Italy
| |
Collapse
|
15
|
Nelson EC, Dixon-Woods M, Batalden PB, Homa K, Van Citters AD, Morgan TS, Eftimovska E, Fisher ES, Ovretveit J, Harrison W, Lind C, Lindblad S. Patient focused registries can improve health, care, and science. BMJ 2016; 354:i3319. [PMID: 27370543 PMCID: PMC5367618 DOI: 10.1136/bmj.i3319] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Eugene Nelson and colleagues call for registries of care data to be transformed into patient centred interactive learning systems
Collapse
Affiliation(s)
- Eugene C Nelson
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - Mary Dixon-Woods
- Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Paul B Batalden
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - Karen Homa
- Dartmouth-Hitchcock Health, Lebanon, NH, USA
| | - Aricca D Van Citters
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - Tamara S Morgan
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - Elena Eftimovska
- Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Elliott S Fisher
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - John Ovretveit
- Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Wade Harrison
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH 03766, USA
| | - Cristin Lind
- Quality Register Center Stockholm, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Staffan Lindblad
- Medical Management Centre, Karolinska Institutet, Stockholm, Sweden Quality Register Center Stockholm, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
16
|
Ieva F, Paganoni AM, Pietrabissa T. Dynamic clustering of hazard functions: an application to disease progression in chronic heart failure. Health Care Manag Sci 2016; 20:353-364. [PMID: 26846620 DOI: 10.1007/s10729-016-9357-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/25/2016] [Indexed: 11/30/2022]
Abstract
We analyse data collected from the administrative datawarehouse of an Italian regional district (Lombardia) concerning patients affected by Chronic Heart Failure. The longitudinal data gathering for each patient hospital readmissions in time, as well as patient-specific covariates, is studied as a realization of non homogeneous Poisson process. Since the aim behind this study is to identify groups of patients behaving similarly in terms of disease progression and then healthcare consumption, we conjectured the time segments between two consecutive hospitalizations to be Weibull distributed in each hidden cluster. Adding a frailty term to take into account the within subjects unknown variability, the corresponding patient-specific hazard functions are reconstructed. Therefore, the comprehensive distribution for each time to event variable is modelled as a Weibull Mixture. We are then able to easily interpret the related hidden groups as healthy, sick, and terminally ill subjects.
Collapse
Affiliation(s)
- Francesca Ieva
- ADAMSS Center & Department of Mathematics "F. Enriques", Università degli Studi di Milano, via Saldini 50, 20133, Milan, Italy
| | - Anna Maria Paganoni
- MOX - Department of Mathematics, Politecnico di Milano, via Bonardi 9, 20133, Milan, Italy.
| | - Teresa Pietrabissa
- MOX - Department of Mathematics, Politecnico di Milano, via Bonardi 9, 20133, Milan, Italy
| |
Collapse
|