Thursday, August 04, 2011

This Is The Sort Of Thing You Can Do When You Have A Developed E-Health Infrastructure.

Two really good examples appeared during the week.

First we had:

Kaiser calls EHR data crucial in genomics project

By Joseph Conn

Posted: July 26, 2011 - 12:30 pm ET

Tags: Electronic Health Records (EHR), Information Technology, Research

Genetics researchers from Kaiser Permanente and the University of California at San Francisco have reached what they describe as a milestone in a two-year research project by genotyping and analyzing the chromosome tips of 100,000 volunteer research subjects.

The genotyping work was funded by a $24.8 million, two-year grant from the National Institutes of Health and conducted by Kaiser Permanente's Research Program on Genes, Environment and Health and by UCSF's Institute for Human Genetics, according to a news release from Kaiser and UCSF.

The Kaiser program focuses on epidemiologic studies of genetic and environmental influences on common health conditions, including asthma, cancer and diabetes. The genetic information was gleaned from saliva swabs taken from Northern California patients with an average age of 65. As part of the project, researchers measured the length of participants' telomeres, described in the release as "tiny units of DNA that bind the ends of chromosomes." Telomeres' length, the release notes, may reflect aging at the cellular level and may be a marker for age-related conditions. Genetic information will now be linked to data gleaned from a participant health survey, each participant's medical records stored in Kaiser's electronic health-record system and state-provided environmental data related to air pollution and water quality as well as "neighborhood characteristics, such as proximity to parks, grocery stores and healthy foods," according to the release.

Kaiser Permanente Northern California's research division founded the genetics-research program in 2005 and began enrolling participants in 2007 with a goal of registering a half-million Kaiser Permanente members by 2014, according to the news release. So far, 188,000 have signed up.

More here:

And then this appeared

EMR data determines statin use doesn't lead to cancer

July 28, 2011 — 10:11am ET | By Janice Simmons

The use of statins, a popular drug class in the U.S. prescribed for such conditions as atherosclerosis and various cardiovascular events, did not appear to increase the risk of cancer among patients, according to a retrospective study appearing this week in the Journal of the American College of Cardiology that reviewed more than 11 million electronic medical records (EMRs).

To study any link between cancer and statin use, Claudio Marelli--of Cincinnati-based S2 Statistical Solutions--and colleagues conducted an analysis using records from January 1990 through February 2009, courtesy of GE Healthcare's Centricity EMR database. Clinical information for more than 30 million patients throughout the U.S. can be found in the database.


Overall, the EMR database analysis of more than 91,000 U.S. adults demonstrated "no statistically significant increased risk of cancer associated with statins," the authors concluded.

For more information:
- check out the Journal of the American College of Cardiology

- read the MedPage Today article

- see the Cardiovascular Business article

More here:

Just as EMRs were very useful in identifying the issues with Vioxx and heart disease it seems that similar work combining records from many patients is continually adding to knowledge.

Of course similar work is going on with EMIS in the UK and we also now have the use of Google and Twitter in monitoring the spread of infectious diseases.

To date it does not appear the GPs in Australia have found themselves contributing to such initiatives in large numbers, although some efforts of this type have been undertaken by Medical Director over the years. Let me know if you know of similar initiatives here in OZ!

See here:

Here is the page on the GP Research Network.

Used well this may be a useful initiative but I am not sure I like the idea of information being used to target improved sales efforts from drug reps!


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