期刊
JOURNAL OF MEDICAL INTERNET RESEARCH
卷 24, 期 2, 页码 -出版社
JMIR PUBLICATIONS, INC
DOI: 10.2196/29279
关键词
COVID-19; clinical decision support; precision medicine; web application; FHIR
资金
- National Cancer Institute [U01 CA231840]
- National Center of Advancing Translational Sciences, National Institutes of Health [UL1 TR001439]
- University of Texas Medical Branch Claude D Pepper Older Americans Independence Center - National Institute on Aging, National Institutes of Health [P30 AG024832]
- MD Anderson Cancer Center
- Bayer
- Pfizer
- Tempus
- National Institutes of Health
- American Association for Cancer Research
This paper describes the creation of the SMART COVID Navigator, a clinical decision support tool designed to assist physicians in treating COVID-19 patients. The tool connects electronic health records with data from observational studies to predict the fatality and severity of COVID-19 progression based on a patient's medical conditions, allowing physicians to determine appropriate treatment strategies.
Background: COVID-19 caused by SARS-CoV-2 has infected 219 million individuals at the time of writing of this paper. A large volume of research findings from observational studies about disease interactions with COVID-19 is being produced almost daily, making it difficult for physicians to keep track of the latest information on COVID-19's effect on patients with certain pre-existing conditions. Objective: In this paper, we describe the creation of a clinical decision support tool, the SMART COVID Navigator, a web application to assist clinicians in treating patients with COVID-19. Our application allows clinicians to access a patient's electronic health records and identify disease interactions from a large set of observational research studies that affect the severity and fatality due to COVID-19. Methods: The SMART COVID Navigator takes a 2-pronged approach to clinical decision support. The first part is a connection to electronic health record servers, allowing the application to access a patient's medical conditions. The second is accessing data sets with information from various observational studies to determine the latest research findings about COVID-19 outcomes for patients with certain medical conditions. By connecting these 2 data sources, users can see how a patient's medical history will affect their COVID-19 outcomes. Results: The SMART COVID Navigator aggregates patient health information from multiple Fast Healthcare Interoperability Resources-enabled electronic health record systems. This allows physicians to see a comprehensive view of patient health records. The application accesses 2 data sets of over 1100 research studies to provide information on the fatality and severity of COVID-19 for several pre-existing conditions. We also analyzed the results of the collected studies to determine which medical conditions result in an increased chance of severity and fatality of COVID-19 progression. We found that certain conditions result in a higher likelihood of severity and fatality probabilities. We also analyze various cancer tissues and find that the probabilities for fatality vary greatly depending on the tissue being examined. Conclusions: The SMART COVID Navigator allows physicians to predict the fatality and severity of COVID-19 progression given a particular patient's medical conditions. This can allow physicians to determine how aggressively to treat patients infected with COVID-19 and to prioritize different patients for treatment considering their prior medical conditions.
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