A Path to Real-World Evidence in Critical Care Using Open-Source Data Harmonization Tools

Smith F Heavner; Wesley Anderson; Rahul Kashyap; Pamela Dasher; Ewy A Mathé; Laura Merson; Philippe J Guerin; Jeff Weaver; Matthew Robinson; Marco Schito; Vishakha K Kumar; Paul Nagy

doi:10.1097/CCE.0000000000000893

A Path to Real-World Evidence in Critical Care Using Open-Source Data Harmonization Tools

Crit Care Explor. 2023 Apr 3;5(4):e0893. doi: 10.1097/CCE.0000000000000893. eCollection 2023 Apr.

Authors

Smith F Heavner^{1

2}, Wesley Anderson³, Rahul Kashyap^{4

5}, Pamela Dasher¹, Ewy A Mathé⁶, Laura Merson⁷, Philippe J Guerin^{8

9}, Jeff Weaver¹⁰, Matthew Robinson¹¹, Marco Schito¹, Vishakha K Kumar¹², Paul Nagy¹³

Affiliations

¹ CURE Drug Repurposing Collaboratory, Critical Path Institute, Tucson, AZ.
² Department of Public Health Sciences, Clemson University, Clemson, SC.
³ Quantitative Medicine, Critical Path Institute, Tucson, AZ.
⁴ Department of Research, WellSpan Health, York, PA.
⁵ Department of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN.
⁶ Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD.
⁷ ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom.
⁸ Infectious Diseases Data Observatory, University of Oxford, Oxford, United Kingdom.
⁹ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
¹⁰ Office of Information Technology, Emory University, Atlanta, GA.
¹¹ Department of Medicine-Infectious Disease, Johns Hopkins University, Baltimore, MD.
¹² Society for Critical Care Medicine, Mount Prospect, IL.
¹³ Johns Hopkins University School of Medicine, Baltimore, MD.

Abstract

COVID-19 highlighted the need for use of real-world data (RWD) in critical care as a near real-time resource for clinical, research, and policy efforts. Analysis of RWD is gaining momentum and can generate important evidence for policy makers and regulators. Extracting high quality RWD from electronic health records (EHRs) requires sophisticated infrastructure and dedicated resources. We sought to customize freely available public tools, supporting all phases of data harmonization, from data quality assessments to de-identification procedures, and generation of robust, data science ready RWD from EHRs. These data are made available to clinicians and researchers through CURE ID, a free platform which facilitates access to case reports of challenging clinical cases and repurposed treatments hosted by the National Center for Advancing Translational Sciences/National Institutes of Health in partnership with the Food and Drug Administration. This commentary describes the partnership, rationale, process, use case, impact in critical care, and future directions for this collaborative effort.

Keywords: Observational Medical Outcomes Partnership (OMOP); critical care; data harmonization; drug repurposing; electronic health record; real-world data.