CODE-EHR best practice framework for the use of structured electronic healthcare records in clinical research

Big data is central to new developments in global clinical science aiming to improve the lives of patients. Technological advances have led to the routine use of structured electronic healthcare records with the potential to address key gaps in clinical evidence. The covid-19 pandemic has demonstrated the potential of big data and related analytics, but also important pitfalls. Verification, validation, and data privacy, as well as the social mandate to undertake research are key challenges. The European Society of Cardiology and the BigData@Heart consortium have brought together a range of international stakeholders, including patient representatives, clinicians, scientists, regulators, journal editors and industry. We propose the CODE-EHR Minimum Standards Framework as a means to improve the design of studies, enhance transparency and develop a roadmap towards more robust and effective utilisation of healthcare data for research purposes

Experimental validation of the electrokinetic theory and development of seismoelectric interferometry by cross-correlation

We experimentally validate a relatively recent electrokinetic formulation of the streaming potential (SP) coefficient as developed by Pride (1994). The start of our investigation focuses on the streaming potential coefficient, which gives rise to the coupling of mechanical and electromagnetic fields. It is found that the theoretical amplitude values of this dynamic SP coefficient are in good agreement with the normalized experimental results over a wide frequency range, assuming no frequency dependence of the bulk conductivity. By adopting the full set of electrokinetic equations, a full-waveform wave propagation model is formulated. We compare the model predictions, neglecting the interface response andmodeling only the coseismic fields, with laboratory measurements of a seismic wave of frequency 500 kHz that generates electromagnetic signals. Agreement is observed between measurement and electrokinetic theory regarding the coseismic electric field. The governing equations are subsequently adopted to study the applicability of seismoelectric interferometry. It is shown that seismic sources at a single boundary location are sufficient to retrieve the 1D seismoelectric responses, both for the coseismic and interface components, in a layered model.Geoscience & EngineeringCivil Engineering and Geoscience

Electrokinetic fields and waves: Theory, experiments and numerical modeling

Geoscience & EngineeringCivil Engineering and Geoscience

Incident coronary events and case fatality in relation to common carotid intima-media thickness.

Objectives. To evaluate the incidence of coronary events (CE) and case fatality in relation to common carotid intima-media thickness (IMT) and carotid plaque over a median follow up of 7 years. Subjects. A total of 5163 Swedish middle-aged men and women with no prior myocardial infarction and/or stroke. Methods and results. The associations amongst B-mode ultrasound determined common carotid IMT, carotid plaque (focal IMT > 1.2 mm) and carotid stenosis (lumen reduction of >15%) and incident CE, were investigated in relation to cardiovascular risk factor levels. Age- and sex-adjusted common carotid IMT, carotid plaque and carotid stenosis were significantly (P < 0.05) related to future CE. Adjustment for established risk factors generally reduced the hazard rate ratios. However, the continuous measure of common carotid IMT, carotid plaque and carotid stenosis were significantly related to incident CE, even after risk factor adjustment. The strength of the associations between common carotid IMT and CE was only to a small extent reduced after adjustment for presence of carotid plaque. There were no statistically significant associations between common carotid IMT, carotid plaque or carotid stenosis and short-term case-fatality rates (28-days mortality) or long-term case-fatality rates (5-years mortality). Conclusions. The results show an association between common carotid IMT and incident CE, independently of cardiovascular risk factors and carotid plaque. However, there was no association with short-term or long-term mortality after a CE

The mondriaan project: The dutch healthcare landscape as a population laboratory

Background: The gap between pre-clinical pharmaceutical research and clinical/epidemiological research hampers optimal benefit-risk assessment and monitoring of new and existing medicines. Many excellent health care databases are available in the Netherlands for pharmaco-epidemiologic and -economic research. However, in isolation these data remain scattered and have limitations with regard to sample sizes and/or detail of the registered information. Objectives: To optimize routine health care databases in the Netherlands for pharmaco-epidemiologic and economic research in order to improve benefit-risk assessment and monitoring of new and existing medicines. Methods: We build an ICT infrastructure for linkage of healthcare/research databases in the Netherlands. To protect privacy, pseudonimisation and linkage was performed by a trusted third party (TTP). A data catalogue was developed to allow queries over the integrated databases which will help in designing pharmacoepidemiologic studies (incl. sample size calculations, assessment of completeness of data). Results: We linked pharmacy records from the National Foundation of Pharmaceutical Statistics (n>12,000,000) on a patient base to several routine health care databases such as the Almere Health Care database (n=160,000), the Utrecht Health Project (n=20,000), and the AGIS claims database (n=1,200,000). Currently we are integrating several other databases in the Netherlands. Conclusions: The project will deliver a large-scale, highquality data platform for innovative pharmaceutical research and provide the tools to improve benefit-risk assessment of medicines