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DOI: 10.3414/ME13-02-0019
Harmonization of Detailed Clinical Models with Clinical Study Data Standards
Publication History
received:
07 June 2013
accepted:
23 April 2014
Publication Date:
22 January 2018 (online)
Summary
Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Managing Interoperability and Complexity in Health Systems”.
Background: Data sharing and integration between the clinical research data management system and the electronic health record system remains a challenging issue. To approach the issue, there is emerging interest in utilizing the Detailed Clinical Model (DCM) approach across a variety of contexts. The Intermountain Healthcare Clinical Element Models (CEMs) have been adopted by the Office of the National Coordinator awarded Strategic Health IT Advanced Research Projects for normalization (SHARPn) project for normalizing patient data from the electronic health records (EHR).
Objective: The objective of the present study is to describe our preliminary efforts toward harmonization of the SHARPn CEMs with CDISC (Clinical Data Interchange Standards Consortium) clinical study data standards.
Methods: We were focused on three generic domains: demographics, lab tests, and medications. We performed a panel review on each data element extracted from the CDISC templates and SHARPn CEMs.
Results: We have identified a set of data elements that are common to the context of both clinical study and broad secondary use of EHR data and discussed outstanding harmonization issues.
Conclusions: We consider that the outcomes would be useful for defining new requirements for the DCM modeling community and ultimately facilitating the semantic interoper-ability between systems for both clinical study and broad secondary use domains.
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References
- 1 El Fadly A, Daniel C, Bousquet C, Dart T, Lastic PY, Degoulet P. Electronic Healthcare Record and clinical research in cardiovascular radiology. HL7 CDA and CDISC ODM interoperability. AMIA Annu Symp Proc. 2007: 216-220.
- 2 Hammond WE, Jaffe C, Kush RD. Healthcare standards development. The value of nurturing collaboration. J AHIMA 2009; 80 (07) 44-50. quiz 51-42.
- 3 The CDISC. http://www.cdisc.org/ Accessed November 6 2012
- 4 Health Level Seven International (HL7). http://www.hl7.org/ Accessed November 6 2012
- 5 The Biomedical Research Integrated Domain Group (BRIDG) Model. http://www.bridgmodel.org/ Accessed November 19 2013
- 6 Coyle JF, Mori AR, Huff SM. Standards for detailed clinical models as the basis for medical data exchange and decision support. Int J Med Inform 2003; 69 2-3 157-174.
- 7 HL7 Detailed Clinical Models. http://wiki.hl7. org/index.php?title=Detailed_Clinical_Models Accessed November 6 2012
- 8 Goossen W, Goossen-Baremans A, van der Zel M. Detailed clinical models: a review. Healthc Inform Res 2010; 16 (04) 201-214.
- 9 Beale T. Archetypes: Constraint-based domain models for future-proof information systems. Eleventh OOPSLA Workshop on Behavioral Semantics: Serving the Customer. Seattle, Washington, USA: Northeastern University; 2002: 16-32.
- 10 Beale T. Archetypes and the EHR. Stud Health Technol Inform 2003; 96: 238-244.
- 11 Huff SM, Rocha RA, Coyle JF, Narus SP. Integrating detailed clinical models into application development tools. Stud Health Technol Inform. 2004; 107 0Pt (02) 1058-1062.
- 12 DCM work at ISO. http://wiki.hl7.org/index.php? title=Detailed_Clinical_Models-DCM_work_at_ ISO Accessed November 16 2013
- 13 ISO/DTS 13972 Health informatics - Detailed clinical models, characteristics and processes. http://www.iso.org/iso/catalogue_detail.htm? csnumber=62416 Accessed April 5 2014
- 14 The Clinical Information Modeling Initiative (CIMI). http://informatics.mayo.edu/CIMI/index. php/Main_Page Accessed November 6 2012
- 15 CIMI - initial public statement. http:// omowizard.wordpress.com/2011/12/14/cimi- initial-public-statement/ Accessed Nov. 6 2012
- 16 Chute CG, Pathak J, Savova GK. et al. The SHARPn project on secondary use of Electronic Medical Record data: progress, plans, and possibilities. AMIA Annu Symp Proc. 2011: 248-256.
- 17 CDISC SHARE. http://www.cdisc.org/cdisc-share Accessed November 6 2012
- 18 Jiang G, Solbrig HR, Iberson-Hurst D, Kush RD, Chute CG. A Collaborative Framework for Representation and Harmonization of Clinical Study Data Elements Using Semantic MediaWiki. AMIA Summits Transl Sci Proc. 2010: 11-15.
- 19 CDISC Standards. http://www.cdisc.org/ standards Accessed November 6 2012
- 20 The ISO/IEC 11179, Information Technology - Metadata registries (MDR). http://metadata- standards.org/11179/ Accessed Nov. 6 2012
- 21 Rea S, Pathak J, Savova G. et al. Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data. The SHARPn project. J Biomed Inform. 2012
- 22 CEM Browser. http://www.clinicalelement.com/ Accessed November 16 2013
- 23 Huff SM, Rocha RA, Solbrig HR, Barnes MW, Schrank SP, Smith M. Linking a medical vocabulary to a clinical data model using Abstract Syntax Notation 1. Methods Inf Med 1998; 37 4-5 440-452.
- 24 Richesson RL, Krischer J. Data standards in clinical research: gaps, overlaps, challenges and future directions. J Am Med Inform Assoc 2007; 14 (06) 687-696.
- 25 Rector A, Rossi A, Consorti MF, Zanstra P. Practical development of re-usable terminologies: GALEN-IN-USE and the GALEN Organisation. Int J Med Inform 1998; 48 1-3 71-84.
- 26 Rogers JE, Price C, Rector AL, Solomon WD, Smejko N. Validating clinical terminology structures: integration and cross-validation of Read Thesaurus and GALEN. Proceedings/AMIA Annual Symposium. 1998: 845-849.
- 27 ISO 21090:2011 Health informatics - Harmonized data types for information interchange. http:// www.iso.org/iso/iso_catalogue/catalogue_tc/ catalogue_detail.htm?csnumber=35646 Accessed June 29 2012
- 28 Jiang G, Solbrig HR, Chute CG. Quality evaluation of value sets from cancer study common data elements using the UMLS semantic groups. J Am Med Inform Assoc 2012; 19 (01) e129-136.
- 29 The OMG Common Terminology Services 2 Standard. http://www.omg.org/spec/CTS2/ Accessed June 29 2012
- 30 Jiang G, Solbrig HR, Evans J. et al. OpenCEM Wiki: A Semantic-Web-based Repository for Supporting Harmonization of Clinical Study Data Standards and Clinical Element Models. Paper presented at: The SHARPn Summit 2012 (Abstract) Rochester, MN, June. 2012: 11-12.
- 31 CIMI Reference Model. https://github.com/ opencimi/rm Accessed April 7 2014
- 32 Jiang G, Evans J, Endle CM, SHA R, Chute CG. Using Semantic Web Technologies for the Generation of Domain Templates to Support Clinical Study Meta-Data Standards. In: Proceedings of the 6th International Workshop on Semantic Web Applications and Tools for Life Sciences. Edinburgh, UK: December 10 2013