Generalizability of kidney transplant data in electronic health records - The Epic Cosmos database vs the Scientific Registry of Transplant Recipients.

Autor:	Mankowski MA; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA. Electronic address: michal.mankowski@nyulangone.org., Bae S; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., Strauss AT; Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA., Lonze BE; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA., Orandi BJ; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Center for Data Science, New York University, New York, New York, USA., Stewart D; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA., Massie AB; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., McAdams-DeMarco MA; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., Oermann EK; Center for Data Science, New York University, New York, New York, USA; Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Radiology, NYU Langone Health, New York, New York, USA; Neuroscience Institute, NYU Langone Health, New York, New York, USA., Habal M; Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA., Iturrate E; Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA., Gentry SE; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., Segev DL; Department of Surgery, NYU Grossman School of Medicine, New York, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA., Axelrod D; Department of Surgery, University Hospitals, Cleveland, Ohio, USA.
Jazyk:	angličtina
Zdroj:	American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2024 Nov 15. Date of Electronic Publication: 2024 Nov 15.
DOI:	10.1016/j.ajt.2024.11.008
Abstrakt:	Developing real-world evidence from electronic health records (EHR) is vital to advancing kidney transplantation (KT). We assessed the feasibility of studying KT using the Epic Cosmos aggregated EHR data set, which includes 274 million unique individuals cared for in 238 US health systems, by comparing it with the Scientific Registry of Transplant Recipients (SRTR). We identified 69 418 KT recipients who underwent transplants between January 2014 and December 2022 in Cosmos (39.4% of all US KT transplants during this period). The demographics and clinical characteristics of recipients captured in Cosmos were consistent with the overall SRTR cohort. Survival estimates were generally comparable, although there were some differences in long-term survival. At 7 years posttransplant, patient survival was 80.4% in Cosmos and 77.8% in SRTR. Multivariable Cox regression showed consistent associations between clinical factors and mortality in both cohorts, with minor discrepancies in the associations between death and both age and race. In summary, Cosmos provides a reliable platform for KT research, allowing EHR-level clinical granularity not available with either the transplant registry or health care claims. Consequently, Cosmos will enable novel analyses to improve our understanding of KT management on a national scale. Competing Interests: Declaration of competing interest The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. Dorry L. Segev has received consulting and speaking honoraria from Sanofi, Novartis, CLS Behring, Jazz Pharmaceuticals, Veloxis, Mallinckrodt, and Thermo Fisher Scientific. Alexandra T. Strauss is a member of the Epic Hepatology Specialty Steering Board. Eric K. Oermann reports consulting with Sofinnova, Google Inc, income from Eikon Therapeutics, and equity in Artisight, Delvi. David Axelrod reports receiving consulting income from CareDx and Specialist Direct. All remaining authors have nothing to disclose. (Copyright © 2024 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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