Electronic medical records as a source of real-world clinical data

Гусев, A. В.; Zingerman, Boris; Tyufilin, D. S.; Zinchenko, V.V.

doi:10.37489/2782-3784-myrwd-13

Cited by 10 publications

(4 citation statements)

References 14 publications

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“…При формировании базы данных применялись различные технологии извлечения информации из электронных медицинских карт, в т.ч. NLP (natural language processing) для анализа неструктурированных текстов, использовалась система управления базами данных PostgreSQL [19]. Скрипты для базы данных были напи-саны на языке программирования PL/pgSQL (Procedural Language/PostGres Structured Query Language).…”

Section: материал и методыunclassified

Clinical characteristics and frequency of anticoagulation in patients with atrial fibrillation and heart failure: results of a retrospective big data analysis

Дружилов

Kuznetsova

Gavrilov³

et al. 2023

Cardiovasc Ther Prev

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Aim. To evaluate the clinical characteristics and frequency of prescribed anticoagulant therapy for patients with atrial fibrillation (AF) and heart failure (HF) in subjects of the Russian Federation based on a retrospective big data analysis using artificial intelligence technologies.Material and methods. For retrospective analysis, information was obtained from the Webiomed predictive analytics platform, which includes depersonalized data from electronic health records of outand/ or inpatients in 6 subjects of the Russian Federation, extracted using artificial intelligence technologies. From the database of patients with AF (n=144431), a group of individuals (n=20970) with an established diagnosis of HF and information on left ventricular ejection fraction (LVEF) was selected.Results. Patients with AF and HF (men, 43,7%; age 72,1±13,2 years; LVEF, 58,9±11,0%) had a history of smoking in 36,6% of cases, hypertension — in 86,7%, type 2 diabetes — in 26,6%, gout — in 2,7%, stage III and IV-V chronic kidney disease — in 50,9 and 15,6%, lower limb peripheral arterial disease — in 15,8%. The incidence of ischemic stroke, LV myocardial infarction and pulmonary embolism was 8,8, 14,7 and 2,4%, respectively. Anticoagulants, including direct oral ones, were administered to patients with AF and HF in 62,5% and 32,0% of cases, respectively. The frequency of their appointment did not significantly differ depending on LVEF.Conclusion. Patients with AF and HF are characterized by significant comorbidity, a higher incidence of cardiovascular events compared with the group of individuals with AF without HF, and an unsatisfactory percentage of anticoagulant therapy.

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Section: материал и методыunclassified

Clinical characteristics and frequency of anticoagulation in patients with atrial fibrillation and heart failure: results of a retrospective big data analysis

Дружилов

Kuznetsova

Gavrilov³

et al. 2023

Cardiovasc Ther Prev

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“…Скрипты были созданы на языке программирования PL/pgSQL (Procedural Language/ PostGres Structured Query Language). Для предобработки, извлечения машиночитаемых данных из неструктурированных медицинских текстов и постобработки полученных результатов применялся язык программирования Python и библиотеки Pandas, scikit-learn, NumPy, pymorphy2 и Gensim [12].…”

Section: материал и методыunclassified

Patients with atrial fibrillation and a low risk of thromboembolic events: prescription rate of anticoagulant therapy according to a retrospective analysis

Druzhilov,

Kuznetsova

2023

Russ J Cardiol

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Aim. To conduct a retrospective analysis of the prevalence of main risk factors for thromboembolic events (TEEs) and the prescription rate of anticoagulant therapy (ACT) in patients with atrial fibrillation (AF) and a low CHA2DS2-VASc score in certain Russian regions using artificial intelligence technologies.Material and methods. The information was obtained from the Webiomed predictive analytics platform. The sample included 87601 patients with AF aged 18-74 years (men, 49,5%, mean age, 59,3±12,3 years, mean CHA2DS2-VASc score, 2,3±1,5) who received care in medical organizations in 6 constituent entities of the Russian Federation in the period from 2016 to 2019. CHA2DS2VASc score of 1 and 2 in a man and a woman, respectively, was regarded as a moderate risk, while score of 0 and 1, respectively, as a low risk of TEEs.Results. There were 22337 (25,5%) patients with AF at moderate risk and 18366 (21,0%) patients at low risk of TEEs. With a moderate risk of TEEs, CHA2DS2-VASc score of 1 in 70,4% of cases was determined by hypertension, while in 15,7% — by age 65-74 years, in 9,0% — by heart failure, in 2,9% — by myocardial infarction and/or peripheral arterial disease, in 2,0% — by type 2 diabetes. In patients with AF and a moderate risk of TEEs, ACT was prescribed in 4927 (22,1%) patients, while with a low risk of TEEs — in 1833 (10,0%). Among patients with AF and a high risk of TEEs (n=46898, 53,5%), 1216 (24,6%) patients with ischemic stroke (IS) did not initially have a high CHA2DS2-VASc risk.Conclusion. In clinical practice, among patients with AF aged 18-74 years, there are quite often individuals with CHA2DS2-VASc score of 1 not associated with sex. These patients need an individualized approach in ACT, which is the basis for prospective studies in order to optimize the assessment of cardioembolic IS risk, as well as to analyze the efficacy and safety of long-term ACT.

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“…Информация о пациентах с ФП взята из платформы прогнозной аналитики "Webiomed", содержащей деперсонифицированные формализованные данные, полученные методом сплошной выборки с помощью различных технологий извлечения информации [23] Для исключения значимого влияния возраста с учетом показанных возрастных различий между подгруппами с выбранными диапазонами рСКФ, частота ИИ, ИМ и назначения АКТ в зависимости от величины анализируемого показателя была определена у мужчин и женщин отдельных возрастных диапазонов: ≤64, 65-74 и ≥75 лет. Данные возрастные диапазоны были выделены в соответствии с вкладом каждого из них в величину риска ТЭО по шкале CHA 2 DS 2 -VASc.…”

Section: материал и методыunclassified

“…Эти факты с учетом более медленной скорости прогрессирования почечной дисфункции у пациентов с ФП при назначении ПОАК по сравнению с варфарином [23] являются убедительным аргументом для их приоритетного назначения в допу-стимых инструкциями к препаратам диапазонах клиренса креатинина.…”

Section: эпидемиология и профилактика сердечно-сосудистых заболеванийunclassified

Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation

Druzhilov,

Kuznetsova,

Druzhilova

et al. 2023

Cardiovasc Ther Prev

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Aim. To compare clinical characteristics of patients with atrial fibrillation (AF) depending on renal filtration function based on a retrospective analysis of data in individual subjects of the Russian Federation (RF).Material and methods. The information was taken from the Webiomed predictive analytics platform, including 80775 patients with AF (men, 42,5%, mean age, 70,0±14,3 years) who underwent outpatient and/or inpatient treatment in medical organizations in 6 Russian subjects in 2016-2019 with data on blood creatinine levels. For comparative analysis, the ranges of estimated glomerular filtration rate (eGFR) were selected: ≥60 ml/min/1,73 m2, 30–59 ml/min/1,73 m2, and <30 ml/min/1,73 m2.Results. The analysis showed that 45128 (55,9%) patients were characterized by eGFR <60 ml/min/1,73 m2, of which in 35212 (78%) patients eGFR was in the range of 30-59 ml/min/1,73 m2, in 9916 (22%) — <30 ml/min/1,73 m2. Patients with eGFR <60 ml/min/1,73 m2 compared with those with eGFR ≥60 ml/min/1,73 m2 were older (75,4±10,9 vs 63,0±15,2 years, p<0,001), had higher incidence of ischemic stroke (IS) (10,9 vs 6,5%, p<0,001), myocardial infarction (MI) (11,5 vs 7,7%, p<0,001) and intracranial hemorrhage (ICH) (1,0 vs 0,7%, p<0,01), as well as higher rate of anticoagulant therapy (ACT) (47,0 vs 33,2%, p<0,001). Men and women with eGFR of 30-59 and <30 ml/min/1,73 m2 in the age ranges ≤64 years and 65-74 years had a higher incidence of IS and MI compared with patients with eGFR ≥60 ml/min/173 m2. The frequency of ICH on warfarin compared with direct oral anticoagulants was significantly higher in the subgroup with eGFR of 30-59 ml/min/1,73 m2 (1,1 vs 0,7%, p<0,01).Conclusion. Patients with AF and eGFR <60 ml/min/1,73 m2 are characterized by greater comorbidity, a higher incidence of IS, MI and ICH compared with patients with AF and eGFR ≥60 ml/min/1,73 m2, while ACT prescription rate as of 2016-2019 in some Russian subjects was unsatisfactory. This emphasizes the need to optimize risk stratification, ACT and algorithms for the prevention of atherothrombotic events, as well as the development of nephroprotective strategies to reduce the rate of progression of renal dysfunction in this cohort of patients.

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Electronic medical records as a source of real-world clinical data

Cited by 10 publications

References 14 publications

Clinical characteristics and frequency of anticoagulation in patients with atrial fibrillation and heart failure: results of a retrospective big data analysis

Clinical characteristics and frequency of anticoagulation in patients with atrial fibrillation and heart failure: results of a retrospective big data analysis

Patients with atrial fibrillation and a low risk of thromboembolic events: prescription rate of anticoagulant therapy according to a retrospective analysis

Atrial fibrillation and chronic kidney disease: main clinical characteristics of patients in selected subjects of the Russian Federation

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