i2b2 Clinical Research Chart

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i2b2 Clinical Research Chart Shawn Murphy MD, Ph.D. Griffin Weber MD, Ph.D. Michael Mendis Vivian Gainer MS Lori Phillips MS Rajesh Kuttan Wensong Pan MS Henry Chueh MD Susanne Churchill Ph.D. John Glaser Ph.D. Isaac Kohane MD, Ph.D.

Use Cases Identifying cohorts for clinical trials Access to human specimens Population health surveillance Observational studies of genetic variants

Technical Overview Formed as a collection of interoperable services provided by i2b2 Cells Loosely coupled Makes no assumptions about proximity Connected by Web services Activity can be directed manually or automatically

i2b2 Environment i2b2 project portal A B C local shared / central Hive of software services and core CRC cells remote Clinical Research Chart

i2b2 Cell: Canonical Hive Unit Business Logic Data Access Data Objects i2b2 HTTP XML (minimum: RESTful, others like SOAP optional) Programmatic Access

Use Case Development of i2b2 technology Enterprise-wide repurposing and distribution of medical record data for research Hospital-wide availability of clinician-driven queries to find research cohorts Suggestion of novel relationships between genes and disease through mutual information theory methods Display of large collections of odds ratios as calculated following environmental exposures (Pharmacovigilance)

Enterprise-wide repurposing and distribution of medical record data for research Project Management Ontology Management Annotating Genomic Data #1 File Repository Data Repository (CRC) Natural Language Processing Identity Management Correlation Analysis De - Identification Of data Workflow Framework Annotating Genomic Data #2 PFT Processing Annotating Imaging Data Enable high performance collection of medical record data for querying and distribution Enterprise web client Create patient cohorts for further investigation Enable discovery within data on enterprise wide scale Relevance networks Pharmacovigilance

Enterprise web client http://services.i2b2.org/webclient/

Workbench display of Mutual Inform. Correlations

Odds Ratios for Diseases expressed in comparing Rosiglitazone vs. Pioglitazone

Use Case Development of i2b2 technology Provide distribution of medical records and tools for their manipulation in supporting specific research projects. Select patients for clinical trials Working out details for calculating odds ratios of pharmacovigilance Annotating images in clinical studies

Set of patients is selected through Enterprise Repository and data is gathered into a data mart EDR Selected patients Data directly from EDR Data from other sources Data imported specifically for project Project Specific Phenotypic Data Automated Queries search for Patients and add Data

Repurpose medical record information for research studies I2b2 Workbench Natural language processing Enable genomic studies Tissue/blood selection Genetic data integration Project Management Ontology Management File Repository Natural Language Processing Identity Management De - Identification Of data Annotating Genomic Data #2 PFT Processing Annotating Genomic Data #1 Data Repository (CRC) Correlation Analysis Workflow Framework Annotating Imaging Data Use of medical record data in clinical studies focused upon genomics and pharmacology

Select patients for clinical trials

Upload Notes Encrypt Notes Create new calculated Concepts I2b2 DB (Data Rep) Application Server Concepts from Text (NLP)

Project data can be added back to Enterprise Repository [ Enterprise Shared Data ] Shared data of Project 1 of Project 2 of Project 3 Ontology Consent/Tracking Security i2b2 DB Project 1 i2b2 DB Project 2 i2b2 DB Project 3

Enterprise Querytool allows: Selection of patient populations through complex queries Specifically targeted population analysis Privacy Management

Project Workbench allows: Patient population medical record review and exploration of data in a targeted population Use of Natural Language Processing Import of batch data sets Workflow support to simulate sequences of operations Export of batch outputs for specific applications Privacy management

Help outside of i2b2 Ontology management NCBO Imaging Research BIRN / XNAT Tissue management Crimson Cross Platform Integration cabig / SHRINE

Extensible Neuroimaging Archive Toolkit (XNAT) used to integrate image management into i2b2 i2b2

Genotype samples and compare to controls

SHRINE (Shared Research Informatics Network) = Distributed Queries i2b2 SHRINE adapter Query Aggregator i2b2 SHRINE adapter cabig SHRINE adapter Central aggregator broadcasts query to local hospital adaptors, which return aggregate counts only

Prototype Screenshot

i2b2 Clinical Research Chart Shawn Murphy MD, Ph.D. Griffin Weber MD, Ph.D. Michael Mendis Vivian Gainer MS Lori Phillips MS Rajesh Kuttan Wensong Pan MS Henry Chueh MD Susanne Churchill Ph.D. John Glaser Ph.D. Isaac Kohane MD, Ph.D.