EU-ADR project Paul Avillach , Fleur Mougin, Michel Joubert, Frantz - - PowerPoint PPT Presentation

FP7 EU-ADR project - MIE 2009 - Sarajevo

A semantic approach for the homogeneous identification of events in eight patient databases: a contribution to the European EU-ADR project

Paul Avillach, Fleur Mougin, Michel Joubert, Frantz Thiessard, Antoine Pariente, Jean-Charles Dufour, Gianluca Trifirò, Giovanni Polimeni, Maria Antonietta Catania, Carlo Giaquinto, Giampiero Mazzaglia, Gianluca Baio, Ron Herings, Rosa Gini, Julia Hippisley-Cox, Mariam Molokhia, Lars Pedersen, Annie Fourrier-Réglat, Miriam Sturkenboom, Marius Fieschi

FP7 EU-ADR project - MIE 2009 - Sarajevo

Objective

The overall objective of the Alert project is the design, development and validation of a computerized system that exploits data from electronic healthcare records and biomedical databases for the early detection of adverse drug reactions.

FP7 EU-ADR project - MIE 2009 - Sarajevo

• FP7 - Grant Agreement no. 215847
• Start date: 1-Feb-2008
• Duration: 42 months
• 15 beneficiaries from 8 countries. 3 Subcontractors
• Budget (total costs): 5.880.600 €
• Funding: 4.500.000 €

Basic Characteristics

FP7 EU-ADR project - MIE 2009 - Sarajevo

• Medical records
• Not spontaneous reporting systems
• More than 30 million European citizens
• 8 heterogeneous databases

Basic Characteristics

FP7 EU-ADR project - MIE 2009 - Sarajevo

• 4 terminologies :

– ICD9-CM – ICD10 – READ CODES – ICPC2

• Free text in 2 languages :

– Italian – Dutch

• Impossibility to create only one same query for all the

databases

• Need of a common semantic basis

heterogeneous databases

FP7 EU-ADR project - MIE 2009 - Sarajevo

FP7 EU-ADR project - MIE 2009 - Sarajevo

458 (ICD9) Hypotension I95.9 (ICD10) Hypotensie, niet gespecificeerd I95.9 (ICD10) Hypotension, unspecified K29022 (ICPC) low blood pressure

• G87z. (RCD)

Hypotension NOS XM02U (RCD) Low blood pressure

Unique Concept: Hypotension

• Riduzione della pressione

arteriosa

• Pressione arteriosa

diminuita

• Pressione arteriosa bassa
• Vascular Hypotension
• Hypotension, Vascular
• Lowered blood pressure
• Fall in blood pressure
• Blood pressure drop arterial
• Blood pressure decreased
• val in bloeddruk
• hypotensie
• bloeddrukval arterieel
• bloeddruk verlaagd
• arteriale bloeddruk verlaagd

Example

FP7 EU-ADR project - MIE 2009 - Sarajevo

• Unified Medical Language

System

• Metathesaurus

– include 148 source vocabularies – ~ 1,8 million concepts (cluster of synonyms)

UMLS version : 2008AB

Resource: the UMLS

FP7 EU-ADR project - MIE 2009 - Sarajevo

• 1. Event
• 2. Event

Description Form (EDF)

• 3. Search

for UMLS concepts

Method for the terminology mapping

FP7 EU-ADR project - MIE 2009 - Sarajevo

C0041909 Upper gastrointestinal hemorrhage

RCD X30Be Upper gastrointest haemorrhage ENG RCD X30Be Upper gastrointestinal haemorrhage ENG RCD X30Be Upper GI - gastrointestinal haemorrhage ENG RCD X30Be Upper GI-gastrointes haemorrh ENG

C0018926 Hematemesis

ICD10 K92.0 Haematemesis ENG ICD9CM 578.0 Hematemesis ENG ICPC D14 Hematemesis/vomiting blood ENG ICPC2P D14001 vomiting out blood ENG ICPC2P D14001 Vomiting;blood ENG ICPC2P D14003 Haematemesis ENG ICPC2P D14003 Hematemesis ENG ICPCDUT D14 Haematemesis/bloed braken DUT ICPCITA D14 Ematemesi/vomito sanguinolento ITA RCD J680. Haematemesis ENG RCD J680. Vomiting blood ENG

C0239293 Esophageal bleeding

ICD9CM 530.82 Esophageal hemorrhage E N G ICPC2ICD10DUT MTHU011694 bloeding; oesofagus D U T ICPC2ICD10DUT MTHU054119

• esofagus; bloeding

D U T R C D J10y0 Haemorrhage of oesophag u s E N G R C D J10y0 Oesophageal haemorrhage E N G R C D Xa7T U Oesophageal bleeding E N G

[…]

• 4. First Draft of Terminology mapping
• 5. Discussion on

Forum and Conference calls for harmonization issues

• 3. Search for

UMLS concepts Method for the terminology mapping

FP7 EU-ADR project - MIE 2009 - Sarajevo

UGIB : 21 Concepts

• Upper gastrointestinal hemorrhage
• Gastrointestinal Hemorrhage
• Hematemesis
• Melena
• Esophageal bleeding
• Acute {gastric|duodenal|peptic} ulcer with hemorrhage (and/or)

perforation

• Acute gastrojejunal ulcer with haemorrhage, without mention of
• bstruction
• Acute gastrojejunal ulcer with hemorrhage and perforation
• Acute gastrojejunal ulcer with hemorrhage
• Atrophic gastritis, with haemorrhage
• Other specified gastritis, with hemorrhage,
• Unspecified gastritis and gastroduodenitis, with hemorrhage
• Acute gastric mucosal erosion

Results

FP7 EU-ADR project - MIE 2009 - Sarajevo

Example 2: Choc Anaphylactique EDF

FP7 EU-ADR project - MIE 2009 - Sarajevo

Missing ICD9CM mapping

manual

Example 2: Choc Anaphylactique

FP7 EU-ADR project - MIE 2009 - Sarajevo

• Consensus founded
• Heterogeneous databases
• Different rules in coding
• Different granularity
• Primary or secondary diagnosis
• Biology results

Discussion

FP7 EU-ADR project - MIE 2009 - Sarajevo

• A projection of UMLS concepts in the

terminologies

• A shared semantic basis for the creation of

queries

• External semantic interoperability

Conclusion

FP7 EU-ADR project - MIE 2009 - Sarajevo

Participating institutions:

• Aarhus University Hospital, Århus Sygehus, Denmark
• Agenzia regionale di Sanità, Italy
• AstraZeneca AB, Sweden
• Erasmus University Medical Center, Netherlands
• Fundació IMIM, Spain
• Health Search - Italian College of General Practitioners, Italy
• Imperial College London, UK
• IRCCS Centro Neurolesi “Bonino-Pulejo”, Italy
• London School of Hygiene & Tropical Medicine, UK
• PHARMO Coöperation UA, Netherlands
• Pedianet - Societa’ Servizi Telematici SRL, Italy
• Tel-Aviv University, Israel
• Università di Milano-Bicocca, Italy
• Université Victor-Segalen Bordeaux II, France
• University of Aveiro – IEETA, Portugal
• University of Nottingham, UK
• University of Santiago de Compostela, Spain
• University Pompeu Fabra, Spain

Consortium Members