ArticleACI open2021
The Cosmos Collaborative: A Vendor-Facilitated Electronic Health Record Data Aggregation Platform.
Article in ACI open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed.
- Comorbidity Associations with Ocular Pain after Cataract Surgery: Overall and Sex-Stratified Analysis.AJO international · 2026Article
- Cystic Fibrosis Heterozygosity as a Risk Factor for Post-ERCP Pancreatitis: Implications for ERCP Risk Stratification in the Cosmos Cohort.Digestive diseases and sciences · 2026Article
- Access and Attrition Across Audiology and Cochlear Implant Care Among Older Adults with Bilateral Sensorineural Hearing Loss.Otology & neurotology open · 2026Article
- Sterol pathway disruption in pregnancy: a link to autism.Molecular psychiatry · 2026Article
- Commensal Dysbiosis Alters Primary Bile Acid Signaling to Drive Mammary Gland Inflammation and Breast Tumor Dissemination.Cancer research · 2026Article
- Evaluation of a Generative Medical Event Foundation Model for Predicting Post-Discharge Trajectories in Emergency Department Abdominal Pain.medRxiv : the preprint server for health sciences · 2026Article
- Article
- Scalable risk stratification of undiagnosed heart failure using routine health data and its association with imaging phenotypes and outcomes.Scientific reports · 2026Article
- Trends in antiseizure medication monotherapy for pediatric epilepsy in the United States.Epilepsia open · 2026Article
- Subtypes of newly diagnosed type 2 diabetes and risk of complications: analysis of electronic health records in the USA.Diabetologia · 2026Article
- Rates of Leucovorin Prescriptions for Children With Autism.JAMA network open · 2026Article
- Article
- Beyond Missingness: Systematizing Methods for Comprehensive Data Fitness Assessment in Clinical Research.Journal of medical Internet research · 2026Article
- Wastewater surveillance reveals patterns of antibiotic resistance across the United States.Nature communications · 2026Article
- Development and validation of a multi-institutional electronic juvenile idiopathic arthritis phenotype.Seminars in arthritis and rheumatism · 2026Article
- Article
- Sex differences in pain in 2 large and diverse US databases.Pain reports · 2026Article
- Privacy and fidelity: The promise of synthetic data in hepatology research.Hepatology (Baltimore, Md.) · 2026Article
- Impact of Social Vulnerability and Allostatic Load on Postoperative Outcomes.Annals of surgical oncology · 2026Article
- Inpatient mortality following hip fracture in the United States: an updated analysis of over one million cases.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveLearning healthcare systems use routinely collected data to generate new evidence that informs future practice. While implementing an electronic health record (EHR) system can facilitate this goal for individual institutions, meaningfully aggregating data from multiple institutions can be more empowering. Cosmos is a cross-institution, single EHR vendor-facilitated data aggregation tool. This work aims to describe the initiative and illustrate its potential utility through several use cases.
methodsCosmos is designed to scale rapidly by leveraging preexisting agreements, clinical health information exchange networks, and data standards. Data are stored centrally as a limited dataset, but the customer facing query tool limits results to prevent patient reidentification.
resultsIn 2 years, Cosmos grew to contain EHR data of more than 60 million patients. We present practical examples illustrating how Cosmos could further efforts in chronic disease surveillance (asthma and obesity), syndromic surveillance (seasonal influenza and the 2019 novel coronavirus), immunization adherence and adverse event reporting (human papilloma virus and measles, mumps, rubella, and varicella vaccination), and health services research (antibiotic usage for upper respiratory infection). DISCUSSION: A low barrier of entry for Cosmos allows for the rapid accumulation of multi-institutional and mostly de-duplicated EHR data to power research and quality improvement queries characteristic of learning healthcare systems. Limitations are being vendor-specific, an "all or none" contribution model, and the lack of control over queries run on an institution's healthcare data.
conclusionCosmos provides a model for within-vendor data standardization and aggregation and a steppingstone for broader intervendor interoperability.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.