Utilizing Clinical Metadata to Predict High-Cost Complications and Treatment Response in IBD: Development of Clinical Decision Support Tools
Abstract
Our proposal addresses the Fiscal Year 2016 Peer Reviewed Medical Research Program Topic Area of Technology Development in Inflammatory Bowel Disease (IBD). IBD is a costly and debilitating disease, significantly affecting quality of life. Our research plans to generate easy-to-use, internet-based tools (similar to a calculator) to determine which patient will go on to have costly disease over the next several years, and/or is unlikely to respond to traditional biologic therapies with anti-TNF medications. We propose using an already available IBD patient registry database that has been developed by the Principal Investigator and the research team at University of Pittsburgh Medical Center (UPMC)/University of Pittsburgh, which was supported by a prior Department of Defense award headed by Dr. Mike Dunn (Brigadier General US Army, retired), who is a co-investigator on this proposal. The UPMC IBD Registry has created a secure system for importing, organizing, and analyzing routinely available clinical information from the electronic medical records of over 3,000 consented IBD patients from January 1, 2009, to the present time. In addition to routine clinical and patient information, the registry database includes important disease activity scores, quality of life scores obtained at the time of clinic visits, and all healthcare charges, which are time-stamped and will be essential to this project. This approach to organizing routine clinical information from the electronic medical record has been highly productive, having generated 88 published scientific abstracts and manuscripts over the past 3 years. The short-term goal is to use accessible patient information and routinely collected prospective clinical data derived from the electronic medical record from over 3,000 IBD patients followed for >7 years, to generate personalized prediction models and tools to assess response to biologic therapy and risk of high-cost complications, including enteric infection and disability for the care of patients with IBD. We will generate a publicly accessible computer-based risk prediction calculator that allows for risk stratification after entering routinely collected patient information. The goal of this web-based technology will be to use routine clinical information to facilitate a personalized clinical approach for treatment and stratification of IBD patients based on severity and phenotype. Personalized approaches for IBD treatment will help to avoid unnecessary exposure to biologic therapies and their associated risks in patients likely to fail a standard biologic treatment (i.e., anti-TNF) approach. Similarly, identifying patients who are at risk for future high-cost complications will provide a window of opportunity for cost-saving outpatient care, proactive lifestyle modifications, and dietary interventions to prevent hospitalization, surgery, infectious complications, or disability. This personalized approach to IBD treatment will positively impact patients and their experience with the disease, avoiding risks, and providing the opportunity for early interventions to avoid debilitating disease complications. Personalization of care will also benefit those taking care of IBD patients, as it will provide insight into disease subgroups and treatment choices, saving time and financial resources from the health system.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710556
Entities
People
- David Binion
Organizations
- United States Army
- University of Pittsburgh