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A real-time integrated framework to support clinical decision making for covid-19 patients

BACKGROUND: The COVID-19 pandemic affected healthcare systems worldwide. Predictive models developed by Artificial Intelligence (AI) and based on timely, centralized and standardized real world patient data could improve management of COVID-19 to achieve better clinical outcomes. The objectives of t...

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Autores principales: Murri, Rita, Masciocchi, Carlotta, Lenkowicz, Jacopo, Fantoni, Massimo, Damiani, Andrea, Marchetti, Antonio, Sergi, Paolo Domenico Angelo, Arcuri, Giovanni, Cesario, Alfredo, Patarnello, Stefano, Antonelli, Massimo, Bellantone, Rocco, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Landolfi, Raffaele, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier B.V. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800500/
https://www.ncbi.nlm.nih.gov/pubmed/35158181
http://dx.doi.org/10.1016/j.cmpb.2022.106655
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author Murri, Rita
Masciocchi, Carlotta
Lenkowicz, Jacopo
Fantoni, Massimo
Damiani, Andrea
Marchetti, Antonio
Sergi, Paolo Domenico Angelo
Arcuri, Giovanni
Cesario, Alfredo
Patarnello, Stefano
Antonelli, Massimo
Bellantone, Rocco
Bernabei, Roberto
Boccia, Stefania
Calabresi, Paolo
Cambieri, Andrea
Cauda, Roberto
Colosimo, Cesare
Crea, Filippo
De Maria, Ruggero
De Stefano, Valerio
Franceschi, Francesco
Gasbarrini, Antonio
Landolfi, Raffaele
Parolini, Ornella
Richeldi, Luca
Sanguinetti, Maurizio
Urbani, Andrea
Zega, Maurizio
Scambia, Giovanni
Valentini, Vincenzo
author_facet Murri, Rita
Masciocchi, Carlotta
Lenkowicz, Jacopo
Fantoni, Massimo
Damiani, Andrea
Marchetti, Antonio
Sergi, Paolo Domenico Angelo
Arcuri, Giovanni
Cesario, Alfredo
Patarnello, Stefano
Antonelli, Massimo
Bellantone, Rocco
Bernabei, Roberto
Boccia, Stefania
Calabresi, Paolo
Cambieri, Andrea
Cauda, Roberto
Colosimo, Cesare
Crea, Filippo
De Maria, Ruggero
De Stefano, Valerio
Franceschi, Francesco
Gasbarrini, Antonio
Landolfi, Raffaele
Parolini, Ornella
Richeldi, Luca
Sanguinetti, Maurizio
Urbani, Andrea
Zega, Maurizio
Scambia, Giovanni
Valentini, Vincenzo
author_sort Murri, Rita
collection PubMed
description BACKGROUND: The COVID-19 pandemic affected healthcare systems worldwide. Predictive models developed by Artificial Intelligence (AI) and based on timely, centralized and standardized real world patient data could improve management of COVID-19 to achieve better clinical outcomes. The objectives of this manuscript are to describe the structure and technologies used to construct a COVID-19 Data Mart architecture and to present how a large hospital has tackled the challenge of supporting daily management of COVID-19 pandemic emergency, by creating a strong retrospective knowledge base, a real time environment and integrated information dashboard for daily practice and early identification of critical condition at patient level. This framework is also used as an informative, continuously enriched data lake, which is a base for several on-going predictive studies. METHODS: The information technology framework for clinical practice and research was described. It was developed using SAS Institute software analytics tool and SAS® Vyia® environment and Open-Source environment R ® and Python ® for fast prototyping and modeling. The included variables and the source extraction procedures were presented. RESULTS: The Data Mart covers a retrospective cohort of 5528 patients with SARS-CoV-2 infection. People who died were older, had more comorbidities, reported more frequently dyspnea at onset, had higher d-dimer, C-reactive protein and urea nitrogen. The dashboard was developed to support the management of COVID-19 patients at three levels: hospital, single ward and individual care level. INTERPRETATION: The COVID-19 Data Mart based on integration of a large collection of clinical data and an AI-based integrated framework has been developed, based on a set of automated procedures for data mining and retrieval, transformation and integration, and has been embedded in the clinical practice to help managing daily care. Benefits from the availability of a Data Mart include the opportunity to build predictive models with a machine learning approach to identify undescribed clinical phenotypes and to foster hospital networks. A real-time updated dashboard built from the Data Mart may represent a valid tool for a better knowledge of epidemiological and clinical features of COVID-19, especially when multiple waves are observed, as well as for epidemic and pandemic events of the same nature (e. g. with critical clinical conditions leading to severe pulmonary inflammation). Therefore, we believe the approach presented in this paper may find several applications in comparable situations even at region or state levels. Finally, models predicting the course of future waves or new pandemics could largely benefit from network of DataMarts.
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spelling pubmed-88005002022-01-31 A real-time integrated framework to support clinical decision making for covid-19 patients Murri, Rita Masciocchi, Carlotta Lenkowicz, Jacopo Fantoni, Massimo Damiani, Andrea Marchetti, Antonio Sergi, Paolo Domenico Angelo Arcuri, Giovanni Cesario, Alfredo Patarnello, Stefano Antonelli, Massimo Bellantone, Rocco Bernabei, Roberto Boccia, Stefania Calabresi, Paolo Cambieri, Andrea Cauda, Roberto Colosimo, Cesare Crea, Filippo De Maria, Ruggero De Stefano, Valerio Franceschi, Francesco Gasbarrini, Antonio Landolfi, Raffaele Parolini, Ornella Richeldi, Luca Sanguinetti, Maurizio Urbani, Andrea Zega, Maurizio Scambia, Giovanni Valentini, Vincenzo Comput Methods Programs Biomed Article BACKGROUND: The COVID-19 pandemic affected healthcare systems worldwide. Predictive models developed by Artificial Intelligence (AI) and based on timely, centralized and standardized real world patient data could improve management of COVID-19 to achieve better clinical outcomes. The objectives of this manuscript are to describe the structure and technologies used to construct a COVID-19 Data Mart architecture and to present how a large hospital has tackled the challenge of supporting daily management of COVID-19 pandemic emergency, by creating a strong retrospective knowledge base, a real time environment and integrated information dashboard for daily practice and early identification of critical condition at patient level. This framework is also used as an informative, continuously enriched data lake, which is a base for several on-going predictive studies. METHODS: The information technology framework for clinical practice and research was described. It was developed using SAS Institute software analytics tool and SAS® Vyia® environment and Open-Source environment R ® and Python ® for fast prototyping and modeling. The included variables and the source extraction procedures were presented. RESULTS: The Data Mart covers a retrospective cohort of 5528 patients with SARS-CoV-2 infection. People who died were older, had more comorbidities, reported more frequently dyspnea at onset, had higher d-dimer, C-reactive protein and urea nitrogen. The dashboard was developed to support the management of COVID-19 patients at three levels: hospital, single ward and individual care level. INTERPRETATION: The COVID-19 Data Mart based on integration of a large collection of clinical data and an AI-based integrated framework has been developed, based on a set of automated procedures for data mining and retrieval, transformation and integration, and has been embedded in the clinical practice to help managing daily care. Benefits from the availability of a Data Mart include the opportunity to build predictive models with a machine learning approach to identify undescribed clinical phenotypes and to foster hospital networks. A real-time updated dashboard built from the Data Mart may represent a valid tool for a better knowledge of epidemiological and clinical features of COVID-19, especially when multiple waves are observed, as well as for epidemic and pandemic events of the same nature (e. g. with critical clinical conditions leading to severe pulmonary inflammation). Therefore, we believe the approach presented in this paper may find several applications in comparable situations even at region or state levels. Finally, models predicting the course of future waves or new pandemics could largely benefit from network of DataMarts. The Authors. Published by Elsevier B.V. 2022-04 2022-01-29 /pmc/articles/PMC8800500/ /pubmed/35158181 http://dx.doi.org/10.1016/j.cmpb.2022.106655 Text en © 2022 The Authors. Published by Elsevier B.V. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Murri, Rita
Masciocchi, Carlotta
Lenkowicz, Jacopo
Fantoni, Massimo
Damiani, Andrea
Marchetti, Antonio
Sergi, Paolo Domenico Angelo
Arcuri, Giovanni
Cesario, Alfredo
Patarnello, Stefano
Antonelli, Massimo
Bellantone, Rocco
Bernabei, Roberto
Boccia, Stefania
Calabresi, Paolo
Cambieri, Andrea
Cauda, Roberto
Colosimo, Cesare
Crea, Filippo
De Maria, Ruggero
De Stefano, Valerio
Franceschi, Francesco
Gasbarrini, Antonio
Landolfi, Raffaele
Parolini, Ornella
Richeldi, Luca
Sanguinetti, Maurizio
Urbani, Andrea
Zega, Maurizio
Scambia, Giovanni
Valentini, Vincenzo
A real-time integrated framework to support clinical decision making for covid-19 patients
title A real-time integrated framework to support clinical decision making for covid-19 patients
title_full A real-time integrated framework to support clinical decision making for covid-19 patients
title_fullStr A real-time integrated framework to support clinical decision making for covid-19 patients
title_full_unstemmed A real-time integrated framework to support clinical decision making for covid-19 patients
title_short A real-time integrated framework to support clinical decision making for covid-19 patients
title_sort real-time integrated framework to support clinical decision making for covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800500/
https://www.ncbi.nlm.nih.gov/pubmed/35158181
http://dx.doi.org/10.1016/j.cmpb.2022.106655
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