Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Chart Review of Patients With COPD, Using Electronic Medical Records and Artificial Intelligence: BigCOPData
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the World
since 2003. Many people suffer from this disease or its complications for many years and die
prematurely. In the European Union, the total direct costs of respiratory diseases are
estimated to be around 6% of the total healthcare budget, with COPD accounting for 56% (38.6
billion Euros) of the costs of respiratory diseases.
In the natural history of COPD, many patients may experience acute exacerbations (AECOPD)
that are described as episodes of sustained worsening of the respiratory symptoms that result
in additional therapy. These episodes of exacerbation that often require been seen in the
emergency department and/or a hospital admission are associated with significant morbidity
and mortality; they are responsible for a significant portion of the economic burden of the
disease too. The pharmacological approach used in the management of AECOPD (inhaled
bronchodilators, corticosteroids, and antibiotics), has the objective to minimize the
negative impact of the current exacerbation and to prevent subsequent events.
Despite the collaborative effort between the European Respiratory Society, the American
Thoracic Society, and others to provide clinical recommendations for the prevention of
AECOPD, there is still a considerable number of patients that are prone to suffer from
recurrent exacerbations and to experience a more severe impairment in health status.
Based on all the above, the aim is to identify the factors potentially associated with
hospital admission in patients with AECOPD in English, French, German, and Spanish, speaking
countries, and to develop a predictive model that predicts the risk of hospitalization in
this group of patients, by using artificial intelligence. In this study proposes to take
advantage of SAVANA, a new clinical platform, created in the context of the era of electronic
medical records (EMRs), to analyse the information included in the electronic medical files
(i.e., big data). This clinical platform is a powerful free-text analysis engine, capable of
meaningfully interpreting the contents of the EMRs, regardless of the management system in
which they operate. In this context, this machine learning analytical method can be used to
build a flexible, customized and automated predictive model using the information available
in EMRs.
The study will be conducted in accordance with legal and regulatory requirements, as well as
with scientific purpose, value and rigor and follow generally accepted research practices
described in the International Conference Harmonization (ICH) Guideline for Good Clinical
Practice, the Helsinki Declaration in its latest edition, Good Pharmacoepidemiology
Practices, and applicable local regulations.
To maintain patient confidentiality, demographic and personal identifying information (e.g.,
initials, date of birth, etc.) will not be collected; only age will be collected. In no case
Savana staff will handle a correspondence table between the anonymized patient codes and
their EMRs. Only the healthcare centre can identify patients. In any case, SEPAR, the study
sponsor, or its partners, will not have gto EMRs. It will only access a report, which will
contain aggregated information on the data obtained as described in this protocol. The final
results will be published.
According to the European Data Protection Authority, an anonymous clinical record is released
from its status as personal data, so that the General Data Protection Regulation no longer
applies. The anonymization is performed at each site by the owner of the information (so that
nobody else has access to that information and so that it is not possible to track it).
All actions will be taken in accordance with the Code of Good Data Protection Practices for
Big Data Projects of the European Data Protection Authority, the European General Data
Protection Regulation or another that may replace it.
In addition, clinical records will never be stored in a location other than the institution
where it is implemented. Savana does not use EMRs from individual patients, but aggregate
clinical information, which is also encrypted and secured. The aggregation of the data
ensures the impossibility of identifying patients or individual centres. The system is based
on the processing of a large amount of information (Big Data), so that the impact of random
errors is minimized. The use of this software is possible nowadays since there has been a
notable improvement in the implementation of EMRs, which may result in the use of this
software in significant investments for the use and better knowledge of the health system.
In summary, this new technology allows a complete dissociation between the data obtained for
the current study and the personal data of the patient, since this information is obtained in
an aggregated and completely anonymous form. This clearly represents an advance in data
protection in the context of classical observational epidemiological studies.
Therefore, only aggregated and completely anonymous data will be obtained, completely
dissociated from the personal data of each patient and centre. The confidentiality of patient
records will be maintained at all times. All study reports will contain only aggregated data
and will not identify patients, doctors or individual centres. At no time during the study,
the sponsor will receive information that may allow the identification of a patient or
individual centre.
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