Cargando…
Phenotyping to Facilitate Accrual for a Cardiovascular Intervention
BACKGROUND: The conventional approach for clinical studies is to identify a cohort of potentially eligible patients and then screen for enrollment. In an effort to reduce the cost and manual effort involved in the screening process, several studies have leveraged electronic health records (EHR) to r...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522233/ https://www.ncbi.nlm.nih.gov/pubmed/31143314 http://dx.doi.org/10.14740/jocmr3830 |
_version_ | 1783419100491415552 |
---|---|
author | Wagholikar, Kavishwar B. Fischer, Christina M. Goodson, Alyssa P. Herrick, Christopher D. Maclean, Taylor E. Smith, Katelyn V. Fera, Liliana Gaziano, Thomas A. Dunning, Jacqueline R. Bosque-Hamilton, Joshua Matta, Lina Toscano, Eloy Richter, Brent Ainsworth, Layne Oates, Michael F. Aronson, Samuel MacRae, Calum A. Scirica, Benjamin M. Desai, Akshay S. Murphy, Shawn N. |
author_facet | Wagholikar, Kavishwar B. Fischer, Christina M. Goodson, Alyssa P. Herrick, Christopher D. Maclean, Taylor E. Smith, Katelyn V. Fera, Liliana Gaziano, Thomas A. Dunning, Jacqueline R. Bosque-Hamilton, Joshua Matta, Lina Toscano, Eloy Richter, Brent Ainsworth, Layne Oates, Michael F. Aronson, Samuel MacRae, Calum A. Scirica, Benjamin M. Desai, Akshay S. Murphy, Shawn N. |
author_sort | Wagholikar, Kavishwar B. |
collection | PubMed |
description | BACKGROUND: The conventional approach for clinical studies is to identify a cohort of potentially eligible patients and then screen for enrollment. In an effort to reduce the cost and manual effort involved in the screening process, several studies have leveraged electronic health records (EHR) to refine cohorts to better match the eligibility criteria, which is referred to as phenotyping. We extend this approach to dynamically identify a cohort by repeating phenotyping in alternation with manual screening. METHODS: Our approach consists of multiple screen cycles. At the start of each cycle, the phenotyping algorithm is used to identify eligible patients from the EHR, creating an ordered list such that patients that are most likely eligible are listed first. This list is then manually screened, and the results are analyzed to improve the phenotyping for the next cycle. We describe the preliminary results and challenges in the implementation of this approach for an intervention study on heart failure. RESULTS: A total of 1,022 patients were screened, with 223 (23%) of patients being found eligible for enrollment into the intervention study. The iterative approach improved the phenotyping in each screening cycle. Without an iterative approach, the positive screening rate (PSR) was expected to dip below the 20% measured in the first cycle; however, the cyclical approach increased the PSR to 23%. CONCLUSIONS: Our study demonstrates that dynamic phenotyping can facilitate recruitment for prospective clinical study. Future directions include improved informatics infrastructure and governance policies to enable real-time updates to research repositories, tooling for EHR annotation, and methodologies to reduce human annotation. |
format | Online Article Text |
id | pubmed-6522233 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-65222332019-05-29 Phenotyping to Facilitate Accrual for a Cardiovascular Intervention Wagholikar, Kavishwar B. Fischer, Christina M. Goodson, Alyssa P. Herrick, Christopher D. Maclean, Taylor E. Smith, Katelyn V. Fera, Liliana Gaziano, Thomas A. Dunning, Jacqueline R. Bosque-Hamilton, Joshua Matta, Lina Toscano, Eloy Richter, Brent Ainsworth, Layne Oates, Michael F. Aronson, Samuel MacRae, Calum A. Scirica, Benjamin M. Desai, Akshay S. Murphy, Shawn N. J Clin Med Res Short Communication BACKGROUND: The conventional approach for clinical studies is to identify a cohort of potentially eligible patients and then screen for enrollment. In an effort to reduce the cost and manual effort involved in the screening process, several studies have leveraged electronic health records (EHR) to refine cohorts to better match the eligibility criteria, which is referred to as phenotyping. We extend this approach to dynamically identify a cohort by repeating phenotyping in alternation with manual screening. METHODS: Our approach consists of multiple screen cycles. At the start of each cycle, the phenotyping algorithm is used to identify eligible patients from the EHR, creating an ordered list such that patients that are most likely eligible are listed first. This list is then manually screened, and the results are analyzed to improve the phenotyping for the next cycle. We describe the preliminary results and challenges in the implementation of this approach for an intervention study on heart failure. RESULTS: A total of 1,022 patients were screened, with 223 (23%) of patients being found eligible for enrollment into the intervention study. The iterative approach improved the phenotyping in each screening cycle. Without an iterative approach, the positive screening rate (PSR) was expected to dip below the 20% measured in the first cycle; however, the cyclical approach increased the PSR to 23%. CONCLUSIONS: Our study demonstrates that dynamic phenotyping can facilitate recruitment for prospective clinical study. Future directions include improved informatics infrastructure and governance policies to enable real-time updates to research repositories, tooling for EHR annotation, and methodologies to reduce human annotation. Elmer Press 2019-06 2019-05-10 /pmc/articles/PMC6522233/ /pubmed/31143314 http://dx.doi.org/10.14740/jocmr3830 Text en Copyright 2019, Wagholikar et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Short Communication Wagholikar, Kavishwar B. Fischer, Christina M. Goodson, Alyssa P. Herrick, Christopher D. Maclean, Taylor E. Smith, Katelyn V. Fera, Liliana Gaziano, Thomas A. Dunning, Jacqueline R. Bosque-Hamilton, Joshua Matta, Lina Toscano, Eloy Richter, Brent Ainsworth, Layne Oates, Michael F. Aronson, Samuel MacRae, Calum A. Scirica, Benjamin M. Desai, Akshay S. Murphy, Shawn N. Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title | Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title_full | Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title_fullStr | Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title_full_unstemmed | Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title_short | Phenotyping to Facilitate Accrual for a Cardiovascular Intervention |
title_sort | phenotyping to facilitate accrual for a cardiovascular intervention |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522233/ https://www.ncbi.nlm.nih.gov/pubmed/31143314 http://dx.doi.org/10.14740/jocmr3830 |
work_keys_str_mv | AT wagholikarkavishwarb phenotypingtofacilitateaccrualforacardiovascularintervention AT fischerchristinam phenotypingtofacilitateaccrualforacardiovascularintervention AT goodsonalyssap phenotypingtofacilitateaccrualforacardiovascularintervention AT herrickchristopherd phenotypingtofacilitateaccrualforacardiovascularintervention AT macleantaylore phenotypingtofacilitateaccrualforacardiovascularintervention AT smithkatelynv phenotypingtofacilitateaccrualforacardiovascularintervention AT feraliliana phenotypingtofacilitateaccrualforacardiovascularintervention AT gazianothomasa phenotypingtofacilitateaccrualforacardiovascularintervention AT dunningjacqueliner phenotypingtofacilitateaccrualforacardiovascularintervention AT bosquehamiltonjoshua phenotypingtofacilitateaccrualforacardiovascularintervention AT mattalina phenotypingtofacilitateaccrualforacardiovascularintervention AT toscanoeloy phenotypingtofacilitateaccrualforacardiovascularintervention AT richterbrent phenotypingtofacilitateaccrualforacardiovascularintervention AT ainsworthlayne phenotypingtofacilitateaccrualforacardiovascularintervention AT oatesmichaelf phenotypingtofacilitateaccrualforacardiovascularintervention AT aronsonsamuel phenotypingtofacilitateaccrualforacardiovascularintervention AT macraecaluma phenotypingtofacilitateaccrualforacardiovascularintervention AT sciricabenjaminm phenotypingtofacilitateaccrualforacardiovascularintervention AT desaiakshays phenotypingtofacilitateaccrualforacardiovascularintervention AT murphyshawnn phenotypingtofacilitateaccrualforacardiovascularintervention |