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未来国家儿童大流行呼吸道疾病严重程度分级框架:美国卫生与公众服务部儿童新冠病毒病数据挑战

A framework for future national pediatric pandemic respiratory disease severity triage: The HHS pediatric COVID-19 data challenge.

作者信息

Bergquist Timothy, Wax Marie, Bennett Tellen D, Moffitt Richard A, Gao Jifan, Chen Guanhua, Telenti Amalio, Maher M Cyrus, Bartha Istvan, Walker Lorne, Orwoll Benjamin E, Mishra Meenakshi, Alamgir Joy, Cragin Bruce L, Ferguson Christopher H, Wong Hui-Hsing, Deslattes Mays Anne, Misquitta Leonie, DeMarco Kerry A, Sciarretta Kimberly L, Patel Sandeep A

机构信息

Sage Bionetworks, Seattle, WA, USA.

United States Department of Health and Human Services, Biomedical Advanced Research and Development Authority, Administration for Strategic Preparedness and Response, Washington, DC, USA.

出版信息

J Clin Transl Sci. 2023 Jul 10;7(1):e175. doi: 10.1017/cts.2023.549. eCollection 2023.

Abstract

INTRODUCTION

With persistent incidence, incomplete vaccination rates, confounding respiratory illnesses, and few therapeutic interventions available, COVID-19 continues to be a burden on the pediatric population. During a surge, it is difficult for hospitals to direct limited healthcare resources effectively. While the overwhelming majority of pediatric infections are mild, there have been life-threatening exceptions that illuminated the need to proactively identify pediatric patients at risk of severe COVID-19 and other respiratory infectious diseases. However, a nationwide capability for developing validated computational tools to identify pediatric patients at risk using real-world data does not exist.

METHODS

HHS ASPR BARDA sought, through the power of competition in a challenge, to create computational models to address two clinically important questions using the National COVID Cohort Collaborative: (1) Of pediatric patients who test positive for COVID-19 in an outpatient setting, who are at risk for hospitalization? (2) Of pediatric patients who test positive for COVID-19 and are hospitalized, who are at risk for needing mechanical ventilation or cardiovascular interventions?

RESULTS

This challenge was the first, multi-agency, coordinated computational challenge carried out by the federal government as a response to a public health emergency. Fifty-five computational models were evaluated across both tasks and two winners and three honorable mentions were selected.

CONCLUSION

This challenge serves as a framework for how the government, research communities, and large data repositories can be brought together to source solutions when resources are strapped during a pandemic.

摘要

引言

由于新冠病毒持续流行、疫苗接种率不完全、存在混淆性呼吸道疾病以及可用的治疗干预措施较少,新冠病毒病仍然是儿科人群的负担。在疫情高峰期间,医院很难有效分配有限的医疗资源。虽然绝大多数儿科感染症状较轻,但也有危及生命的例外情况,这凸显了主动识别有患重症新冠病毒病和其他呼吸道传染病风险的儿科患者的必要性。然而,目前尚不存在利用真实世界数据开发经过验证的计算工具来识别有风险的儿科患者的全国性能力。

方法

美国卫生与公众服务部助理部长帮办生物医学高级研究与发展局(HHS ASPR BARDA)通过挑战赛的竞争力量,利用国家新冠病毒队列协作组织(National COVID Cohort Collaborative)创建计算模型,以解决两个临床重要问题:(1)在门诊环境中新冠病毒检测呈阳性的儿科患者中,哪些人有住院风险?(2)新冠病毒检测呈阳性且已住院的儿科患者中,哪些人有需要机械通气或心血管干预的风险?

结果

本次挑战赛是联邦政府为应对突发公共卫生事件而开展的首次多机构协调计算挑战赛。对两项任务中的55个计算模型进行了评估,选出了两名优胜者和三名荣誉奖获得者。

结论

本次挑战赛为在疫情期间资源紧张时,政府、研究团体和大型数据存储库如何联合起来寻找解决方案提供了一个框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ec9/10514686/b8617b1be8ac/S2059866123005496_fig1.jpg

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