BMC Med Inform Decis Mak - Extension of the primary care research object model (PCROM) as clinical research information model (CRIM) for the learning healthcare system.

Tópicos

{ data(3963) clinic(1234) research(1004) }
{ patient(2315) diseas(1263) diabet(1191) }
{ care(1570) inform(1187) nurs(1089) }
{ perform(999) metric(946) measur(919) }
{ take(945) account(800) differ(722) }
{ process(1125) use(805) approach(778) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ model(3480) simul(1196) paramet(876) }
{ implement(1333) system(1263) develop(1122) }
{ data(1714) softwar(1251) tool(1186) }
{ learn(2355) train(1041) set(1003) }
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{ imag(1947) propos(1133) code(1026) }
{ method(1219) similar(1157) match(930) }
{ concept(1167) ontolog(924) domain(897) }
{ research(1218) medic(880) student(794) }
{ cancer(2502) breast(956) screen(824) }
{ studi(1410) differ(1259) use(1210) }
{ data(2317) use(1299) case(1017) }
{ health(1844) social(1437) communiti(874) }
{ survey(1388) particip(1329) question(1065) }
{ decis(3086) make(1611) patient(1517) }
{ bind(1733) structur(1185) ligand(1036) }
{ featur(3375) classif(2383) classifi(1994) }
{ studi(2440) review(1878) systemat(933) }
{ control(1307) perform(991) simul(935) }
{ howev(809) still(633) remain(590) }
{ spatial(1525) area(1432) region(1030) }
{ state(1844) use(1261) util(961) }
{ model(2656) set(1616) predict(1553) }
{ sampl(1606) size(1419) use(1276) }
{ can(981) present(881) function(850) }
{ high(1669) rate(1365) level(1280) }
{ use(1733) differ(960) four(931) }
{ detect(2391) sensit(1101) algorithm(908) }
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{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ patient(2837) hospit(1953) medic(668) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ time(1939) patient(1703) rate(768) }
{ use(2086) technolog(871) perceiv(783) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ use(976) code(926) identifi(902) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

CKGROUND: Patient data from general practices is already used for many types of epidemiological research and increasingly, primary care systems to facilitate randomized clinical trials. The EU funded project TRANSFoRm aims to create a "Learning Healthcare System" at a European level that is able to support all types of research using primary care data, to recruit patients and follow patients in clinical studies and to improve diagnosis and therapy. The implementation of such a Learning Healthcare System needs an information model for clinical research (CRIM), as an informational backbone to integrate aspects of primary care with clinical trials and database searches.METHODS: Workflow descriptions and corresponding data objects of two clinical use cases (Gastro-Oesophageal Reflux Disease and Type 2 Diabetes) were described in UML activity diagrams. The components of activity diagrams were mapped to information objects of PCROM (Primary Care Research Object Model) and BRIDG (Biomedical Research Integrated Domain Group) and evaluated. The class diagram of PCROM was adapted to comply with workflow descriptions.RESULTS: The suitability of PCROM, a primary care information model already used for clinical trials, to act as an information model for TRANSFoRm was evaluated and resulted in its extension with 14 new information object types, two extensions of existing objects and the introduction of two new high-ranking concepts (CARE area and ENTRY area). No PCROM component was redundant. Our result illustrates that in primary care based research an important but underestimated portion of research activity takes place in the area of care (e.g. patient consultation, screening, recruitment and response to adverse events). The newly introduced CARE area for care-related research activities accounts for this shift and includes Episode of Care and Encounter as two new basic elements. In the ENTRY area different aspects of data collection were combined, including data semantics for observations, assessment activities, intervention activities and patient reporting to enable case report form (CRF) based data collection combined with decision support.CONCLUSIONS: Research with primary care data needs an extended information model that covers research activities at the care site which are characteristic for primary care based research and the requirements of the complicated data collection processes.

Resumo Limpo

ckground patient data general practic alreadi use mani type epidemiolog research increas primari care system facilit random clinic trial eu fund project transform aim creat learn healthcar system european level abl support type research use primari care data recruit patient follow patient clinic studi improv diagnosi therapi implement learn healthcar system need inform model clinic research crim inform backbon integr aspect primari care clinic trial databas searchesmethod workflow descript correspond data object two clinic use case gastrooesophag reflux diseas type diabet describ uml activ diagram compon activ diagram map inform object pcrom primari care research object model bridg biomed research integr domain group evalu class diagram pcrom adapt compli workflow descriptionsresult suitabl pcrom primari care inform model alreadi use clinic trial act inform model transform evalu result extens new inform object type two extens exist object introduct two new highrank concept care area entri area pcrom compon redund result illustr primari care base research import underestim portion research activ take place area care eg patient consult screen recruit respons advers event newli introduc care area carerel research activ account shift includ episod care encount two new basic element entri area differ aspect data collect combin includ data semant observ assess activ intervent activ patient report enabl case report form crf base data collect combin decis supportconclus research primari care data need extend inform model cover research activ care site characterist primari care base research requir complic data collect process

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