Nottke Amanda, Alan Sophia, Brimble Elise, Cardillo Anthony B, Henderson Lura, Littleford Hana E, Rojahn Susan, Sage Heather, Taylor Jessica, West-Odell Lisandra, Berk Alexandra
Ciitizen, San Francisco, CA 94112, United States.
Invitae, San Francisco, CA 94103, United States.
JAMIA Open. 2024 May 17;7(2):ooae041. doi: 10.1093/jamiaopen/ooae041. eCollection 2024 Jul.
To validate and demonstrate the clinical discovery utility of a novel patient-mediated, medical record collection and data extraction platform developed to improve access and utilization of real-world clinical data.
Clinical variables were extracted from the medical records of 1011 consented patients with breast cancer. To validate the extracted data, case report forms completed using the structured data output of the platform were compared to manual chart review for 50 randomly-selected patients with metastatic breast cancer. To demonstrate the platform's clinical discovery utility, we identified 194 patients with early-stage clinical data who went on to develop distant metastases and utilized the platform-extracted data to assess associations between time to distant metastasis (TDM) and early-stage tumor histology, molecular type, and germline status.
The platform-extracted data for the validation cohort had 97.6% precision (91.98%-100% by variable type) and 81.48% recall (58.15%-95.00% by variable type) compared to manual chart review. In our discovery cohort, the shortest TDM was significantly associated with metaplastic (739.0 days) and inflammatory histologies (1005.8 days), HR-/HER2- molecular types (1187.4 days), and positive status (1042.5 days) as compared to other histologies, molecular types, and negative status, respectively. Multivariable analyses did not produce statistically significant results.
The precision and recall of platform-extracted clinical data are reported, although specificity could not be assessed. The data can generate clinically-relevant insights.
The structured real-world data produced by a novel patient-mediated, medical record-extraction platform are reliable and can power clinical discovery.
验证并展示一个新开发的患者介导的病历收集和数据提取平台的临床发现效用,该平台旨在改善真实世界临床数据的获取和利用。
从1011名同意参与的乳腺癌患者的病历中提取临床变量。为验证提取的数据,将使用该平台结构化数据输出完成的病例报告表与50名随机选择的转移性乳腺癌患者的手工病历审查结果进行比较。为展示该平台的临床发现效用,我们识别出194例具有早期临床数据且随后发生远处转移的患者,并利用该平台提取的数据评估远处转移时间(TDM)与早期肿瘤组织学、分子类型和种系状态之间的关联。
与手工病历审查相比,验证队列中平台提取的数据精度为97.6%(按变量类型为91.98%-100%),召回率为81.48%(按变量类型为58.15%-95.00%)。在我们的发现队列中,与其他组织学、分子类型和阴性状态相比,最短的TDM分别与化生组织学(739.0天)和炎症组织学(1005.8天)、HR-/HER2-分子类型(1187.4天)以及阳性状态(1042.5天)显著相关。多变量分析未产生具有统计学意义的结果。
报告了平台提取的临床数据的精度和召回率,尽管无法评估特异性。这些数据可以产生与临床相关的见解。
一个新的患者介导的病历提取平台产生的结构化真实世界数据是可靠的,可为临床发现提供支持。