International electronic health record-derived COVID-19 clinical course profiles: the 4CE consortium

Abstract

We leveraged the largely untapped resource of electronic health record data to address critical clinical and epidemiological questions about Coronavirus Disease 2019 (COVID-19). To do this, we formed an international consortium (4CE) of 96 hospitals across five countries (www.covidclinical.net). Contributors utilized the Informatics for Integrating Biology and the Bedside (i2b2) or Observational Medical Outcomes Partnership (OMOP) platforms to map to a common data model. The group focused on temporal changes in key laboratory test values. Harmonized data were analyzed locally and converted to a shared aggregate form for rapid analysis and visualization of regional differences and global commonalities. Data covered 27,584 COVID-19 cases with 187,802 laboratory tests. Case counts and laboratory trajectories were concordant with existing literature. Laboratory tests at the time of diagnosis showed hospital-level differences equivalent to country-level variation across the consortium partners. Despite the limitations of decentralized data generation, we established a framework to capture the trajectory of COVID-19 disease in patients and their response to interventions.

Agile analytics to support rapid knowledge pipelines

“…The paper by the International Consortium for Clinical Characterization of patients with SARS-CoV-2 by EHR (4CE) describes just such an extraordinary response to the COVID-19 pandemic 3 . An international collaboration of 96 hospitals across five countries was assembled to create the means to produce insights through a decentralized platform.…”

Potential limitations in COVID-19 machine learning due to data source variability: A case study in the nCov2019 dataset

“…Recently, the COVID-19 4CE (Consortium for Clinical Characterization of COVID-19 by EHR) DRN found significant variation between countries and between their hospitals regarding laboratory results. 15 …”

“…The emergence of COVID-19 international data sharing initiatives and DRNs have a huge potential benefit for COVID-19 research. 15 , 27 , 28 The ideal goal is to provide high-quality, homogeneous data, but this is not always straightforward. Using standard formats is the first step toward consistent COVID-19 data representation in multisite settings.…”

Towards clinical data-driven eligibility criteria optimization for interventional COVID-19 clinical trials

“… 28 , 29 In an international study that included 95 hospitals across 5 countries, the laboratory trajectories including hepatic and renal function were consistent on the day of COVID-19 diagnosis. 30 However, the characteristics of the COVID-19 patient population may be evolving as the pandemic progresses and its epicenters move geographically. Further studies are warranted to test the generalizability of the results to cohorts with different demographics or comorbidities.…”