Evidence map›Paper›PMID 35994859›Full record

ArticleEpilepsy research2022

A replicable, open-source, data integration method to support national practice-based research & quality improvement systems.

Marta Fernandes, Maria A Donahue, Dan Hoch, Sydney Cash, Sahar Zafar, Claire Jacobs, Mackenzie Hosford, P Emanuela Voinescu, Brandy Fureman, Jeffrey Buchhalter and 3 more

Open access · greenAbstract read
In one paragraph

Article in Epilepsy research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Marta FernandesDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Clinical Data Animation Center (CDAC), MGH, Boston, MA, United States. Electronic address: mbentofernandes@mgh.harvard.edu.
Maria A DonahueDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States; The NeuroValue Lab, MGH, Boston, MA, United States. Electronic address: mdonahue@mgh.harvard.edu.
Dan HochDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: dhoch@mgh.harvard.edu.
Sydney CashDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: scash@mgh.harvard.edu.
Sahar ZafarDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: sfzafar@mgh.harvard.edu.
Claire JacobsDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: claire.jacobs@mgh.harvard.edu.
Mackenzie HosfordDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: mhosford@mgh.harvard.edu.
P Emanuela VoinescuHarvard Medical School, Boston, MA, United States; Department of Neurology, Division of Epilepsy, Division of Women's Health, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: pevoinescu@bwh.harvard.edu.
Brandy FuremanEpilepsy Foundation of America, United States. Electronic address: bfureman@efa.org.
Jeffrey BuchhalterDepartment of Pediatrics, University of Calgary School of Medicine, Calgary, Canada. Electronic address: buchhalterj@gmail.com.
Christopher Michael McGrawDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: cmmcgraw@mgh.harvard.edu.
M Brandon WestoverDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Clinical Data Animation Center (CDAC), MGH, Boston, MA, United States; McCance Center for Brain Health, MGH, Boston, MA, United States. Electronic address: mwestover@mgh.harvard.edu.
Lidia M V R MouraDepartment of Neurology, Massachusetts General Hospital (MGH), Boston, MA, United States; Harvard Medical School, Boston, MA, United States; The NeuroValue Lab, MGH, Boston, MA, United States. Electronic address: lidia.moura@mgh.harvard.edu.
Massachusetts General Hospital · USHarvard University · USEpilepsy Foundation · USUniversity of Calgary · CA

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Tradeoffs in the Design of Public Long-Term Care BenefitsP01AG032952 · NIA · HARVARD MEDICAL SCHOOL · PI Laura Hatfield · 2009 to 2026
$39.0M
Health Promotion and Disease Prevention Research CenterU48DP006377 · DP · EMORY UNIVERSITY · PI KEGLER, MICHELLE C · 2018 to 2023
$13.5M
COVID-19 and Acute Medical Care: Impact on Dementia PatientsR01AG062282 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI HSU, JOHN · 2018 to 2022
$4.5M
Comparative Safety of Seizure Prophylaxis within the Medicare ProgramR01AG073410 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI Lidia Maria Veras Rocha de Moura · 2021 to 2026
$4.1M
Integrative Motor Activity Biomarker for the Risk of Alzheimer's RiskRF1AG064312 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI HU, KUN · 2019 to 2019
$3.6M
Multimodal Network Connectivity Architecture (MOCA) of the Brain and its Role in the Recovery of Consciousness in Comatose Cardiac Arrest PatientsR01NS102574 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, DAVID MATTHEW, WU, ONA · 2018 to 2022
$3.4M
Investigation of Sleep in the Intensive Care Unit (ICU-SLEEP)R01NS102190 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$3.2M
Big Data and Deep Learning for the Interictal-Ictal-Injury ContiuumR01NS107291 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI WESTOVER, MICHAEL BRANDON · 2018 to 2022
$2.8M
Establishing a Brain Health Index from the Sleep ElectroencephalogramRF1NS120947 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S, THOMAS, ROBERT JOSEPH · 2021 to 2021
$2.4M
Developing a Zebrafish Model of Slc6a1/GAT1 Hypofunction and an In Vitro Assay to Identify Novel TreatmentsK08NS118107 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI MCGRAW, CHRISTOPHER · 2020 to 2024
$1.1M
Treatment Strategies in Geriatric EpilepsyK08AG053380 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI MOURA, LIDIA MARIA VERAS ROCHA DE · 2017 to 2021
$842k
ACL HHS U48DP006377NCATS NIH HHS UL1 TR002541NCCDPHP CDC HHS U48 DP006377NIA NIH HHS K08 AG053380NIA NIH HHS P01 AG032952NIA NIH HHS R01 AG062282NIA NIH HHS R01 AG073410NIA NIH HHS RF1 AG064312NINDS NIH HHS K08 NS118107NINDS NIH HHS R01 NS102190NINDS NIH HHS R01 NS102574NINDS NIH HHS R01 NS107291NINDS NIH HHS RF1 NS120947
6 · The paper itself

Abstract

objectivesThe Epilepsy Learning Healthcare System (ELHS) was created in 2018 to address measurable improvements in outcomes for people with epilepsy. However, fragmentation of data systems has been a major barrier for reporting and participation. In this study, we aimed to test the feasibility of an open-source Data Integration (DI) method that connects real-life clinical data to national research and quality improvement (QI) systems.

methodsThe ELHS case report forms were programmed as EPIC SmartPhrases at Mass General Brigham (MGB) in December 2018 and subsequently as EPIC SmartForms in June 2021 to collect actionable, standardized, structured epilepsy data in the electronic health record (EHR) for subsequent pull into the external national registry of the ELHS. Following the QI methodology in the Chronic Care Model, 39 providers, epileptologists and neurologists, incorporated the ELHS SmartPhrase into their clinical workflow, focusing on collecting diagnosis of epilepsy, seizure type according to the International League Against Epilepsy, seizure frequency, date of last seizure, medication adherence and side effects. The collected data was stored in the Enterprise Data Warehouse (EDW) without integration with external systems. We developed and validated a DI method that extracted the data from EDW using structured query language and later preprocessed using text mining. We used the ELHS data dictionary to match fields in the preprocessed notes to obtain the final structured dataset with seizure control information. For illustration, we described the data curated from the care period of 12/2018-12/2021.

resultsThe cohort comprised a total of 1806 patients with a mean age of 43 years old (SD: 17.0), where 57% were female, 80% were white, and 84% were non-Hispanic/Latino. Using our DI method, we automated the data mining, preprocessing, and exporting of the structured dataset into a local database, to be weekly accessible to clinicians and quality improvers. During the period of SmartPhrase implementation, there were 5168 clinic visits logged by providers documenting each patient's seizure type and frequency. During this period, providers documented 59% patients having focal seizures, 35% having generalized seizures and 6% patients having another type. Of the cohort, 45% patients had private insurance. The resulting structured dataset was bulk uploaded via web interface into the external national registry of the ELHS.

conclusionsStructured data can be feasibly extracted from text notes of epilepsy patients for weekly reporting to a national learning healthcare system.

Indexed as

EpilepsyQuality ImprovementAdultCohort StudiesElectronic Health RecordsFemaleHumansMaleSeizuresEpilepsyInternational League Against EpilepsyLearning Health SystemQuality ImprovementSeizure controlText analytics

Identifiers

PMID35994859
PMCPMC9810436
OpenAlexW4292254877

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.