Matoba Tetsuya, Kohro Takahide, Fujita Hideo, Nakayama Masaharu, Kiyosue Arihiro, Miyamoto Yoshihiro, Nishimura Kunihiro, Hashimoto Hideki, Antoku Yasuaki, Nakashima Naoki, Ohe Kazuhiko, Ogawa Hisao, Tsutsui Hiroyuki, Nagai Ryozo
Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences.
Department of Medical Informatics, Jichi Medical University.
Int Heart J. 2019 Mar 20;60(2):264-270. doi: 10.1536/ihj.18-113. Epub 2019 Feb 22.
The utilization of electronic medical records and multimodal medical data is an ideal approach to build a real-time and precision registry type study with a smaller effort and cost, which may fill a gap between evidence-based medicine and the real-world clinical practice. The Japan Ischemic heart disease Multimodal Prospective data Acquisition for preCision Treatment (J-IMPACT) project aimed to build an clinical data registry system that electronically collects not only medical records, but also multimodal data, including coronary angiography and percutaneous coronary intervention (PCI) report, in standardized data formats for clinical studies.The J-IMPACT system comprises the standardized structured medical information exchange (SS-MIX), coronary angiography and intervention reporting system (CAIRS), and multi-purpose clinical data repository system (MCDRS) interconnected within the institutional network. In order to prove the concept, we acquired multimodal medical data of 6 consecutive cases that underwent PCI through the J-IMPACT system in a single center. Data items regarding patient background, laboratory data, prescriptions, and PCI/cardiac catheterization report were correctly acquired through the J-IMPACT system, and the accuracy of the multimodal data of the 4 categories was 100% in all 6 cases.The application of J-IMPACT system to clinical studies not only fills the gaps between randomized clinical trials and real-world medicine, but may also provide real-time big data that reinforces precision treatment for each patient.
利用电子病历和多模态医学数据是一种理想的方法，可通过较少的工作量和成本构建实时、精准的注册型研究，这可能填补循证医学与真实世界临床实践之间的差距。日本缺血性心脏病多模态精准治疗前瞻性数据采集（J-IMPACT）项目旨在构建一个临床数据注册系统，以标准化数据格式电子收集不仅包括医疗记录，还包括多模态数据，如冠状动脉造影和经皮冠状动脉介入治疗（PCI）报告，用于临床研究。J-IMPACT系统由机构网络内相互连接的标准化结构化医疗信息交换（SS-MIX）、冠状动脉造影和介入报告系统（CAIRS）以及多用途临床数据存储库系统（MCDRS）组成。为了验证这一概念，我们在一个中心通过J-IMPACT系统获取了连续6例接受PCI治疗患者的多模态医学数据。通过J-IMPACT系统正确获取了有关患者背景、实验室数据、处方以及PCI/心导管检查报告的数据项，并且在所有6例患者中，这4类多模态数据的准确性均为100%。J-IMPACT系统在临床研究中的应用不仅填补了随机临床试验与真实世界医学之间的差距，还可能提供强化对每位患者精准治疗的实时大数据。
