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Verspoor K. The Evolution of Clinical Knowledge During COVID-19: Towards a Global Learning Health System. Yearb Med Inform 2021; 30:176-184. [PMID: 34479389 PMCID: PMC8416229 DOI: 10.1055/s-0041-1726503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES We examine the knowledge ecosystem of COVID-19, focusing on clinical knowledge and the role of health informatics as enabling technology. We argue for commitment to the model of a global learning health system to facilitate rapid knowledge translation supporting health care decision making in the face of emerging diseases. METHODS AND RESULTS We frame the evolution of knowledge in the COVID-19 crisis in terms of learning theory, and present a view of what has occurred during the pandemic to rapidly derive and share knowledge as an (underdeveloped) instance of a global learning health system. We identify the key role of information technologies for electronic data capture and data sharing, computational modelling, evidence synthesis, and knowledge dissemination. We further highlight gaps in the system and barriers to full realisation of an efficient and effective global learning health system. CONCLUSIONS The need for a global knowledge ecosystem supporting rapid learning from clinical practice has become more apparent than ever during the COVID-19 pandemic. Continued effort to realise the vision of a global learning health system, including establishing effective approaches to data governance and ethics to support the system, is imperative to enable continuous improvement in our clinical care.
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Affiliation(s)
- Karin Verspoor
- School of Computing Technologies, RMIT University, Melbourne VIC 3000 Australia
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne VIC 3010 Australia
- School of Computing and Information Systems, The University of Melbourne, Melbourne VIC 3010 Australia
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2
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Brasil S, Taccone FS, Wayhs SY, Tomazini BM, Annoni F, Fonseca S, Bassi E, Lucena B, Nogueira RDC, De-Lima-Oliveira M, Bor-Seng-Shu E, Paiva W, Turgeon AF, Jacobsen Teixeira M, Malbouisson LMS. Cerebral Hemodynamics and Intracranial Compliance Impairment in Critically Ill COVID-19 Patients: A Pilot Study. Brain Sci 2021; 11:874. [PMID: 34208937 PMCID: PMC8301789 DOI: 10.3390/brainsci11070874] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: One of the possible mechanisms by which the new coronavirus (SARS-Cov2) could induce brain damage is the impairment of cerebrovascular hemodynamics (CVH) and intracranial compliance (ICC) due to the elevation of intracranial pressure (ICP). The main objective of this study was to assess the presence of CVH and ICC alterations in patients with COVID-19 and evaluate their association with short-term clinical outcomes. Methods: Fifty consecutive critically ill COVID-19 patients were studied with transcranial Doppler (TCD) and non-invasive monitoring of ICC. Subjects were included upon ICU admission; CVH was evaluated using mean flow velocities in the middle cerebral arteries (mCBFV), pulsatility index (PI), and estimated cerebral perfusion pressure (eCPP), while ICC was assessed by using the P2/P1 ratio of the non-invasive ICP curve. A CVH/ICC score was computed using all these variables. The primary composite outcome was unsuccessful in weaning from respiratory support or death on day 7 (defined as UO). Results: At the first assessment (n = 50), only the P2/P1 ratio (median 1.20 [IQRs 1.00-1.28] vs. 1.00 [0.88-1.16]; p = 0.03) and eICP (14 [11-25] vs. 11 [7-15] mmHg; p = 0.01) were significantly higher among patients with an unfavorable outcome (UO) than others. Patients with UO had a significantly higher CVH/ICC score (9 [8-12] vs. 6 [5-7]; p < 0.001) than those with a favorable outcome; the area under the receiver operating curve (AUROC) for CVH/ICC score to predict UO was 0.86 (95% CIs 0.75-0.97); a score > 8.5 had 63 (46-77)% sensitivity and 87 (62-97)% specificity to predict UO. For those patients undergoing a second assessment (n = 29), after a median of 11 (5-31) days, all measured variables were similar between the two time-points. No differences in the measured variables between ICU non-survivors (n = 30) and survivors were observed. Conclusions: ICC impairment and CVH disturbances are often present in COVID-19 severe illness and could accurately predict an early poor outcome.
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Affiliation(s)
- Sérgio Brasil
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Fabio Silvio Taccone
- Department of Intensive Care, Universitè Libre de Bruxelles, 1000 Brussels, Belgium; (F.S.T.); (F.A.)
| | - Sâmia Yasin Wayhs
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Bruno Martins Tomazini
- Department of Intensive Care, Universidade de São Paulo, São Paulo 05403-000, Brazil; (B.M.T.); (S.F.); (E.B.); (B.L.); (L.M.S.M.)
| | - Filippo Annoni
- Department of Intensive Care, Universitè Libre de Bruxelles, 1000 Brussels, Belgium; (F.S.T.); (F.A.)
| | - Sérgio Fonseca
- Department of Intensive Care, Universidade de São Paulo, São Paulo 05403-000, Brazil; (B.M.T.); (S.F.); (E.B.); (B.L.); (L.M.S.M.)
| | - Estevão Bassi
- Department of Intensive Care, Universidade de São Paulo, São Paulo 05403-000, Brazil; (B.M.T.); (S.F.); (E.B.); (B.L.); (L.M.S.M.)
| | - Bruno Lucena
- Department of Intensive Care, Universidade de São Paulo, São Paulo 05403-000, Brazil; (B.M.T.); (S.F.); (E.B.); (B.L.); (L.M.S.M.)
| | - Ricardo De Carvalho Nogueira
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Marcelo De-Lima-Oliveira
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Edson Bor-Seng-Shu
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Wellingson Paiva
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Alexis Fournier Turgeon
- Division of Critical Care Medicine and the Department of Anesthesiology, Université Laval, Québec City, QC G1V 0A6, Canada;
| | - Manoel Jacobsen Teixeira
- Division of Neurosurgery, Department of Neurology, Universidade de São Paulo, São Paulo 05403-000, Brazil; (S.Y.W.); (R.D.C.N.); (M.D.-L.-O.); (E.B.-S.-S.); (W.P.); (M.J.T.)
| | - Luiz Marcelo Sá Malbouisson
- Department of Intensive Care, Universidade de São Paulo, São Paulo 05403-000, Brazil; (B.M.T.); (S.F.); (E.B.); (B.L.); (L.M.S.M.)
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Haroon S, Subramanian A, Cooper J, Anand A, Gokhale K, Byne N, Dhalla S, Acosta-Mena D, Taverner T, Okoth K, Wang J, Chandan JS, Sainsbury C, Zemedikun DT, Thomas GN, Parekh D, Marshall T, Sapey E, Adderley NJ, Nirantharakumar K. Renin-angiotensin system inhibitors and susceptibility to COVID-19 in patients with hypertension: a propensity score-matched cohort study in primary care. BMC Infect Dis 2021; 21:262. [PMID: 33722197 PMCID: PMC7957446 DOI: 10.1186/s12879-021-05951-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality. METHODS We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome. RESULTS The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality. CONCLUSION Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.
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Affiliation(s)
- Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jennifer Cooper
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Astha Anand
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Krishna Gokhale
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Samir Dhalla
- The Health Improvement Network (THIN), London, UK
| | | | - Thomas Taverner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kelvin Okoth
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jingya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christopher Sainsbury
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Diabetes, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasglow, UK
| | | | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Dhruv Parekh
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Department of Acute Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Elizabeth Sapey
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Department of Acute Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- PIONEER, The Health Data Research UK Hub in Acute Care, Birmingham, UK
| | - Nicola J Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Midlands Health Data Research UK, Birmingham, UK
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Mayer MA, Vidal-Alaball J, Puigdellívol-Sánchez A, Marín Gomez FX, Leis A, Mendioroz Peña J. Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study. JMIR Public Health Surveill 2021; 7:e25452. [PMID: 33496668 PMCID: PMC7871981 DOI: 10.2196/25452] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Background The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15). Conclusions We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.
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Affiliation(s)
- Miguel Angel Mayer
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Anna Puigdellívol-Sánchez
- Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain.,CAP Anton de Borja, Consorci Sanitari de Terrassa, Terrassa, Spain.,Unitat d'Anatomia Humana Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Francesc X Marín Gomez
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.,Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Angela Leis
- Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jacobo Mendioroz Peña
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.,COVID-19 Response Unit, Department of Health, Generalitat de Catalunya, Barcelona, Spain
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Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers and the Risk of SARS-CoV-2 Infection or Hospitalization With COVID-19 Disease: A Systematic Review and Meta-Analysis. Am J Ther 2020; 29:e74-e84. [PMID: 33395057 DOI: 10.1097/mjt.0000000000001319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND SARS-CoV-2 infects its target cells via angiotensin converting enzyme 2 receptor, a membrane-bound protein found on the surface of many human cells. Treatment with angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptors blockers (ARB) has been shown to increase angiotensin converting enzyme 2 expression by up to 5-fold. AREAS OF UNCERTAINTY These findings coupled with observations of the high prevalence and mortality among SARS-CoV-2-infected patients with underlying cardiovascular disease have led to a speculation that ACEIs/ARBs may predispose to higher risk of being infected with SARS-CoV-2. Therefore, we systematically reviewed the literature and performed a meta-analysis of the association between prior use of ACEIs and ARBs and the risk of SARS-CoV-2 infection or hospitalization due to COVID-19 disease. DATA SOURCES We searched Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus, and Medrxiv.org preprint server until June 18, 2020. THERAPEUTIC ADVANCES Ten studies (6 cohorts and 4 case control) that enrolled a total of 23,892 patients and 853,369 controls were eligible for inclusion in our meta-analysis. One study was excluded from the analysis because of high risk of bias. Prior use of ACEIs was not associated with an increased risk of acquiring SARS-CoV-2 or hospitalization due to COVID-19 disease, odds ratio 0.98, 95% confidence interval (0.91-1.05), I2 = 15%. Similarly, prior use of ARBs was not associated with an increased risk of acquiring SARS-CoV-2, odds ratio 1.04, 95% confidence interval (0.98-1.10), I2 = 0%. CONCLUSION Cumulative evidence suggests that prior use of ACEIs or ARBs is not associated with a higher risk of COVID-19 or hospitalization due to COVID-19 disease. Our results provide a reassurance to the public not to discontinue prescribed ACEIs/ARBs because of fear of COVID-19.
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Cordeanu EM, Jambert L, Severac F, Lambach H, Tousch J, Heitz M, Mirea C, Hamadé A, Younes W, Frantz AS, Merdji H, Schini-Kerth V, Bilbault P, Meziani F, Ohlmann P, Andres E, Stephan D. Outcomes of COVID-19 Hospitalized Patients Previously Treated with Renin-Angiotensin System Inhibitors. J Clin Med 2020; 9:E3472. [PMID: 33126565 PMCID: PMC7692895 DOI: 10.3390/jcm9113472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin-angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56-79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, "RASi" (n = 282) and "RASi-free" (n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of ≥5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57-1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73-1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders.
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Affiliation(s)
- Elena-Mihaela Cordeanu
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Lucas Jambert
- Department of Vascular Medicine, Mulhouse Regional Hospital, 68100 Mulhouse, France; (L.J.); (A.H.)
| | - Francois Severac
- Division of Public Health, Methodology and Biostatistics, University Hospitals of Strasbourg, 67091 Strasbourg, France;
| | - Hélène Lambach
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Jonathan Tousch
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Marie Heitz
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Corina Mirea
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Amer Hamadé
- Department of Vascular Medicine, Mulhouse Regional Hospital, 68100 Mulhouse, France; (L.J.); (A.H.)
| | - Waël Younes
- Department of Vascular Medicine, Colmar Regional Hospital, 68000 Colmar, France;
| | - Anne-Sophie Frantz
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
| | - Hamid Merdji
- Intensive care and Reanimation Department, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.M.); (F.M.)
| | - Valérie Schini-Kerth
- UMR 1260 INSERM Regenerative Nanomedecine, Faculty of Pharmacy, Strasbourg University, 67400 Illkirch, France;
| | - Pascal Bilbault
- Emergency Department, Strasbourg Regional University Hospital, 67091 Strasbourg, France;
| | - Ferhat Meziani
- Intensive care and Reanimation Department, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.M.); (F.M.)
| | - Patrick Ohlmann
- Cardiology Department, Strasbourg Regional University Hospital, 67091 Strasbourg, France;
| | - Emmanuel Andres
- Internal Medicine Department, Strasbourg Regional University Hospital, 67091 Strasbourg, France;
| | - Dominique Stephan
- Department of Hypertension, Vascular Disease and Clinical Pharmacology, Strasbourg Regional University Hospital, 67091 Strasbourg, France; (H.L.); (J.T.); (M.H.); (C.M.); (A.-S.F.); (D.S.)
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Schulz WL, Kvedar JC, Krumholz HM. Agile analytics to support rapid knowledge pipelines. NPJ Digit Med 2020; 3:108. [PMID: 32864471 PMCID: PMC7438323 DOI: 10.1038/s41746-020-00309-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wade L. Schulz
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06510 USA
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, 1 Church Street, New Haven, CT 06510 USA
| | - Joseph C. Kvedar
- Partners HealthCare and Harvard Medical School, Boston, MA 02115 USA
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, 1 Church Street, New Haven, CT 06510 USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510 USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT 06510 USA
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