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. 2010 Nov-Dec;17(6):652-62.
doi: 10.1136/jamia.2009.002477.

Development and evaluation of a common data model enabling active drug safety surveillance using disparate healthcare databases

Stephanie J Reisinger  1 , Patrick B Ryan, Donald J O'Hara, Gregory E Powell, Jeffery L Painter, Edward N Pattishall, Jonathan A Morris
Affiliations

Development and evaluation of a common data model enabling active drug safety surveillance using disparate healthcare databases

Stephanie J Reisinger et al. J Am Med Inform Assoc. 2010 Nov-Dec.

Abstract

Objective: Active drug safety surveillance may be enhanced by analysis of multiple observational healthcare databases, including administrative claims and electronic health records. The objective of this study was to develop and evaluate a common data model (CDM) enabling rapid, comparable, systematic analyses across disparate observational data sources to identify and evaluate the effects of medicines.

Design: The CDM uses a person-centric design, with attributes for demographics, drug exposures, and condition occurrence. Drug eras, constructed to represent periods of persistent drug use, are derived from available elements from pharmacy dispensings, prescriptions written, and other medication history. Condition eras aggregate diagnoses that occur within a single episode of care. Drugs and conditions from source data are mapped to biomedical ontologies to standardize terminologies and enable analyses of higher-order effects.

Measurements: The CDM was applied to two source types: an administrative claims and an electronic medical record database. Descriptive statistics were used to evaluate transformation rules. Two case studies demonstrate the ability of the CDM to enable standard analyses across disparate sources: analyses of persons exposed to rofecoxib and persons with an acute myocardial infarction.

Results: Over 43 million persons, with nearly 1 billion drug exposures and 3.7 billion condition occurrences from both databases were successfully transformed into the CDM. An analysis routine applied to transformed data from each database produced consistent, comparable results.

Conclusion: A CDM can normalize the structure and content of disparate observational data, enabling standardized analyses that are meaningfully comparable when assessing the effects of medicines.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
CDM schema.
Figure 2
Figure 2
Schematic of the Person Timeline Common Data Model.
Figure 3
Figure 3
Data transformation process.
Figure 4
Figure 4
Demographic summary of rofecoxib cohort in each transformed database.
Figure 5
Figure 5
Demographic summary of the acute myocardial infarction (AMI) cohort in each transformed database.
Figure 6
Figure 6
Comparison of concomitant medications within each transformed database for the rofecoxib cohort.
Figure 7
Figure 7
Comparison of concomitant medications occurring during acute myocardial infarction Condition Eras, within each transformed database.
See this image and copyright information in PMC

References

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MeSH terms