Weekly OHDSI Digest - 14Dec2016

MauraBeaton · December 12, 2016, 11:14pm

OHDSI MEETINGS THIS WEEK

Architecture Workgroup - Thursday at 1pm ET
Webex: https://jjconferencing.webex.com/mw3000/mywebex/default.do?service=1&main_url=%2Fmc3000%2Fe.do%3Fsiteurl%3Djjconferencing%26AT%3DMI%26EventID%3D283835502%26MTID%3Dmb7e839a762fbdaab0608f27500679223%26Host%3DQUhTSwAAAALyageAgcuAzkXBwXtvSQo68mr7eYO0HxmjwiiQlO24aYFcB8fE5PhzipREHF2PUFYlNiDTCigGeeVqVSb-RPTI0%26FrameSet%3D2&siteurl=jjconferencing&nomenu=true
Call-in toll-free number: 1-877-5659999 (US)
Call-in number: 1-617-9392838 (US)
Attendee access code: 498 480 37

Population-Level Estimation Workgroup - Wednesday at 2am ET, 8am CET
https://meetings.webex.com/collabs/#/meetings/detail?uuid=M6WE9AOKFETH2VEFPVCZWWBIT0-D1JL&rnd=626260.34165

LAERTES Workgroup - Tuesday at pm ET
https://global.gotomeeting.com/join/530277469
United States: +1 (224) 501-3217
Sweden: +46 (0) 853 527 836
Access Code: 530-277-469

ANNOUNCEMENTS

OHDSI F2F - Save the date for the next OHDSI collaborator F2F on March 17-18th

OHDSI Symposium - Tutorial videos now available! Check them out here: http://www.ohdsi.org/past-symposia/

COMMUNITY PUBLICATIONS

Implementation of clinical decision support in young children with acute gastroenteritis: a randomized controlled trial at the emergency department.

ncbi.nlm.nih.gov

Implementation of clinical decision support in young children with acute gastroenteritis: a randomized controlled trial at the emergency department.

D Geurts, E de Vos-Kerkhof, S Polinder, E Steyerberg, J van der Lei, H Moll and R Oostenbrink, European journal of pediatrics, Feb 2017

Acute gastroenteritis (AGE) is one of the most frequent reasons for young children to visit emergency departments (EDs). We aimed to evaluate (1) feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE and (2) the impact on diagnostics, treatment, and costs compared with usual care by attending physician. A randomized controlled trial was performed in 222 children, aged 1 month to 5 years at the ED of the Erasmus MC-Sophia Children's hospital in The Netherlands ( 2010-2012). Outcome included (1) feasibility, measured by compliance of the nurses, and (2) length of stay (LOS) at the ED, the number of diagnostic tests, treatment, follow-up, and costs. Due to failure of post-ED weight measurement, we could not evaluate weight difference as measure for dehydration. Patient characteristics were comparable between the intervention (N = 113) and the usual care group (N = 109). Implementation of the clinical decision support system proved a high compliance rate. The standardized use of oral ORS (oral rehydration solution) significantly increased from 52 to 65%(RR2.2, 95%CI 1.09-4.31 p < 0.05). We observed no differences in other outcome measures.Implementation of nurse-guided clinical decision support system on rehydration treatment in children with AGE showed high compliance and increase standardized use of ORS, without differences in other outcome measures. What is Known: • Acute gastroenteritis is one of the most frequently encountered problems in pediatric emergency departments. • Guidelines advocate standardized oral treatment in children with mild to moderate dehydration, but appear to be applied infrequently in clinical practice. What is New: • Implementation of a nurse-guided clinical decision support system on treatment of AGE in young children showed good feasibility, resulting in a more standardized ORS use in children with mild to moderate dehydration, compared to usual care. • Given the challenges to perform research in emergency care setting, the ED should be experienced and adequately equipped, especially during peak times.

Pathogenic Mutations in Cancer-Predisposing Genes: A Survey of 300 Patients with Whole-Genome Sequencing and Lifetime Electronic Health Records.

ncbi.nlm.nih.gov

Pathogenic Mutations in Cancer-Predisposing Genes: A Survey of 300 Patients with Whole-Genome Sequencing and Lifetime Electronic Health Records.

KY He, Y Zhao, EW McPherson, Q Li, F Xia, C Weng, K Wang and MM He, PloS one, 2016

It is unclear whether and how whole-genome sequencing (WGS) data can be used to implement genomic medicine. Our objective is to retrospectively evaluate whether WGS can facilitate improving prevention and care for patients with susceptibility to cancer syndromes.We analyzed genetic mutations in 60 autosomal dominant cancer-predisposition genes in 300 deceased patients with WGS data and nearly complete long-term (over 30 years) medical records. To infer biological insights from massive amounts of WGS data and comprehensive clinical data in a short period of time, we developed an in-house analysis pipeline within the SeqHBase software framework to quickly identify pathogenic or likely pathogenic variants. The clinical data of the patients who carried pathogenic and/or likely pathogenic variants were further reviewed to assess their clinical conditions using their lifetime EHRs. Among the 300 participants, 5 (1.7%) carried pathogenic or likely pathogenic variants in 5 cancer-predisposing genes: one in APC, BRCA1, BRCA2, NF1, and TP53 each. When assessing the clinical data, each of the 5 patients had one or more different types of cancers, fully consistent with their genetic profiles. Among these 5 patients, 2 died due to cancer while the others had multiple disorders later in their lifetimes; however, they may have benefited from early diagnosis and treatment for healthier lives, had the patients had genetic testing in their earlier lifetimes.We demonstrated a case study where the discovery of pathogenic or likely pathogenic germline mutations from population-wide WGS correlates with clinical outcome. The use of WGS may have clinical impacts to improve healthcare delivery.