Exploring Opportunities for Clinical Data Warehouse Enhancement Through Data Catalog Integration

Secondary use of clinical health data implies a prior integration of mostly heterogenous and multidimensional data sets. A clinical data warehouse addresses the technological and organizational framework conditions required for this, by making any data available for analysis. However, users of a data warehouse often do not have a comprehensive overview of all available data and only know about their own data in their own systems - a situation which is also referred to as 'data siloed state'. This problem can be addressed and ultimately solved by implementation of a data catalog. Its core function is a search engine, which allows for searching the metadata collected from different data sources and thereby accessing all data there is. With this in mind, we conducted an explorative online market survey followed by vendor comparison as a pre-requisite for system selection of a data catalog. Assessment of vendor performance was based on seven predetermined and weighted selection criteria. Although three vendors achieved the highest score, results were lying closely together. Detailed investigations and test installations are needed for further narrowing down the selection process.

Hypergraph Based Data Model for Complex Health Data Exploration and Its Implementation in PREDIMED Clinical Data Warehouse

Within the PREDIMED Clinical Data Warehouse (CDW) of Grenoble Alpes University Hospital (CHUGA), we have developed a hypergraph based operational data model, aiming at empowering physicians to explore, visualize and qualitatively analyze interactively the complex and massive information of the patients treated in CHUGA. This model constitutes a central target structure, expressed in a dual form, both graphical and formal, which gathers the concepts and their semantic relations into a hypergraph whose implementation can easily be manipulated by medical experts. The implementation is based on a property graph database linked to an interactive graphical interface allowing to navigate through the data and to interact in real time with a search engine, visualization and analysis tools. This model and its agile implementation allow for easy structural changes inherent to the evolution of techniques and practices in the health field. This flexibility provides adaptability to the evolution of interoperability standards.

How to Optimize Connection Between PACS and Clinical Data Warehouse: A Web Service Approach Based on Full Metadata Integration

Clinical image data analysis is an active area of research. Integrating such data in a Clinical Data Warehouse (CDW) implies to unlock the PACS and RIS and to address interoperability and semantics issues. Based on specific functional and technical requirements, our goal was to propose a web service (I4DW) that allows users to query and access pixel data from a CDW by fully integrating and indexing imaging metadata. Here, we present the technical implementation of this workflow as well as the evaluation we carried out using a prostate cancer cohort use case. The query mechanism relies on a Dicom metadata hierarchy dynamically generated during the ETL Process. We evaluated the Dicom data transfer performance of I4DW, and found mean retrieval times of 5.94 seconds and 0.9 seconds to retrieve a complete DICOM series from the PACS and all metadata of a series. We could retrieve all patients and imaging tests of the prostate cancer cohort with a precision of 0.95 and a recall of 1. By leveraging the CMOVE method, our approach based on the Dicom protocol is scalable and domain-neutral. Future improvement will focus on performance optimization and de identification.

AP-HP Health Data Space (AHDS) to the Test of the Covid-19 Pandemic

Sharing observational and interventional health data within a common data space enables university hospitals to leverage such data for biomedical discovery and moving towards a learning health system.

OBJECTIVE

To describe the AP-HP Health Data Space (AHDS) and the IT services supporting piloting, research, innovation and patient care.

METHODS

Built on three pillars - governance and ethics, technology and valorization - the AHDS and its major component, the Clinical Data Warehouse (CDW) have been developed since 2015.

RESULTS

The AP-HP CDW has been made available at scale to AP-HP both healthcare professionals and public or private partners in January 2017. Supported by an institutional secured and high-performance cloud and an ecosystem of tools, mostly open source, the AHDS integrates a large amount of massive healthcare data collected during care and research activities. As of December 2021, the AHDS operates the electronic data capture for almost +840 clinical trials sponsored by AP-HP, the CDW is enabling the processing of health data from more than 11 million patients and generated +200 secondary data marts from IRB authorized research projects. During the Covid-19 pandemic, AHDS has had to evolve quickly to support administrative professionals and caregivers heavily involved in the reorganization of both patient care and biomedical research.

CONCLUSION

The AP-HP Data Space is a key facilitator for data-driven evidence generation and making the health system more efficient and personalized.

Indexing Imaging Reports for Data Sharing: A Study of Mapping Using RadLex Playbook and LOINC

New use cases and the need for quality control and imaging data sharing in health studies require the capacity to align them to reference terminologies. We are interested in mapping the local terminology used at our center to describe imaging procedures to reference terminologies for imaging procedures (RadLex Playbook and LOINC/RSNA Radiology Playbook). We performed a manual mapping of the 200 most frequent imaging report titles at our center (i.e. 73.2% of all imaging exams). The mapping method was based only on information explicitly stated in the titles. The results showed 57.5% and 68.8% of exact mapping to the RadLex and LOINC/RSNA Radiology Playbooks, respectively. We identified the reasons for the mapping failure and analyzed the issues encountered.

Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

INTRODUCTION

We investigated the efficacy of a urethral catheter alone for intraperitoneal perforation during transurethral resection of bladder tumor (TURBT).

PATIENTS AND METHODS

We retrospectively evaluated the medical records of 4,543 patients who underwent TURBT from January 2000 to December 2017 using the Clinical Data Warehouse system. The clinicopathologic characteristics, recurrence-free survival, and progression-free survival were compared between the patient groups with intraperitoneal perforation treated with the Foley catheter alone, extraperitoneal perforation, and matched control TURBT.

RESULTS

Intraperitoneal perforation and extraperitoneal perforation were observed in 16 (35.6%) and 29 (64.4%) patients, respectively. In the intraperitoneal perforation group, 11 (68.8%), 2 (12.5%), and 3 (18.8%) patients were treated with the Foley catheter alone, additional percutaneous drainage, and delayed open surgery, respectively. The use of the Foley catheter alone in patients with intraperitoneal perforation of smaller size than the cystoscope or no pelvic radiotherapy history showed improved efficacy without sequelae or therapeutic delay. One of the 2 patients with the size of the intraperitoneal perforation larger than the cystoscope was successfully treated with the Foley catheter alone, whereas the other patient underwent delayed surgical repair. There was no difference in recurrence-free survival and progression-free survival of the intraperitoneal perforation treated with the Foley catheter alone compared to those of the matched control TURBT (p = 0.909, p = 0.518) and the extraperitoneal perforation (p = 0.458, p = 0.699).

CONCLUSIONS

Intraperitoneal perforation rarely occurred during TURBT. In the case of intraperitoneal perforation of size smaller than cystoscopy or without pelvic radiotherapy history, treatment with the Foley alone showed successful improvement and safe oncological results. Therefore, treatment with the urethral catheter alone can be carefully considered when an intraperitoneal perforation smaller than the cystoscope size or without pelvic radiotherapy history occurs.

Semantic Cross-Mapping Execution of Data in the Perinatal Registry of the Netherlands

INTRODUCTION

The electronically submitted data from midwives and hospitals to the Netherlands perinatal registry vary significantly in their data definitions, and electronic message versions. The purpose of this article is to describe the semantic cross-mapping tool and execution procedure to prepare the data for statistical analysis.

METHODS

requirements analysis, design, development and testing.

RESULTS

The tool for governance of versions of datasets, CIMs, data, and value sets is designed, developed, and tested. The test is based on the data-mart of version PRN 1.3 based data from 2019. Data are semantically cross mapped to current version perinatology data 2.2.

CONCLUSION

The cross-mapping of PRN 1.3 data to perinatology 2.2 data are defined in the tool, testing revealed this mapping is successful.

eHOP Clinical Data Warehouse: From a Prototype to the Creation of an Inter-Regional Clinical Data Centers Network

Creation of networks such as clinical data centers within the hospital enables efficient exploitation of clinical data from a local to an inter-regional scope. This work present the structuration of the French Western Clinical Data Center Network (FWCDCN) conducted between 2016 and 2018. As of November 2018, FWCDCD is compounded with 7 institutions. CDW of the combinded Clinical Data Centers (CDC) contains the data of over 4 million patients followed since 2000.

Factors Associated with Increased Adoption of a Research Data Warehouse

The increased demand of clinical data for the conduct of clinical and translational research incentivized repurposing of the University of Arkansas for Medical Sciences' enterprise data warehouse (EDW) to meet researchers' data needs. The EDW was renamed the Arkansas Clinical Data Repository (AR-CDR), underwent content enhancements, and deployed a self-service cohort estimation tool in late of 2016. In an effort to increase adoption of the AR-CDR, a team of physician informaticist and information technology professionals conducted various informational sessions across the UAMS campus to increase awareness of the AR-CDR and the informatics capabilities. The restructuring of the data warehouse resulted in four-fold utilization increase of the AR-CDR data services in 2017. To assess acceptance rates of the AR-CDR and quantify outcomes of services provided, Everett Rogers' diffusion of innovation (DOI) framework was applied, and a survey was distributed. Results show the factors that had impact on increased adoption were: presence of physician informaticist to mediate interactions between researchers and analysts, data quality, communication with and engagement of researchers, and the AR-CDR's team responsiveness and customer service mindset.