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J Am Med Inform Assoc. 2013 Jul-Aug;20(4):696-9. doi: 10.1136/amiajnl-2012-001355. Epub 2013 Mar 20.

External phenome analysis enables a rational federated query strategy to detect changing rates of treatment-related complications associated with multiple myeloma.

Author information

1
Department of Medicine, Division of Hematology and Oncology, Vanderbilt University, Nashville, Tennessee 37232, USA. jeremy.warner@vanderbilt.edu

Abstract

Electronic health records (EHRs) are increasingly useful for health services research. For relatively uncommon conditions, such as multiple myeloma (MM) and its treatment-related complications, a combination of multiple EHR sources is essential for such research. The Shared Health Research Information Network (SHRINE) enables queries for aggregate results across participating institutions. Development of a rational search strategy in SHRINE may be augmented through analysis of pre-existing databases. We developed a SHRINE query for likely non-infectious treatment-related complications of MM, based upon an analysis of the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC II) database. Using this query strategy, we found that the rate of likely treatment-related complications significantly increased from 2001 to 2007, by an average of 6% a year (p=0.01), across the participating SHRINE institutions. This finding is in keeping with increasingly aggressive strategies in the treatment of MM. This proof of concept demonstrates that a staged approach to federated queries, using external EHR data, can yield potentially clinically meaningful results.

PMID:
23515788
PMCID:
PMC3721159
DOI:
10.1136/amiajnl-2012-001355
[Indexed for MEDLINE]
Free PMC Article
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