title: Data Extraction and Management in Networks of Observational Health Care Databases for Scientific Research: A Comparison of EU-ADR, OMOP, Mini-Sentinel and MATRICE Strategies.
abstract: BACKGROUND
  We see increased use of existing observational data in order to achieve fast and transparent production of empirical evidence in health care research. Multiple databases are often used to increase power, to assess rare exposures or outcomes, or to study diverse populations. For privacy and sociological reasons, original data on individual subjects can't be shared, requiring a distributed network approach where data processing is performed prior to data sharing.
  We created a conceptual framework distinguishing three steps in local data processing: (1) data reorganization into a data structure common across the network; (2) derivation of study variables not present in original data; and (3) application of study design to transform longitudinal data into aggregated data sets for statistical analysis. We applied this framework to four case studies to identify similarities and differences in the United States and Europe: Exploring and Understanding Adverse Drug Reactions by Integrative Mining of Clinical Records and Biomedical Knowledge (EU-ADR), Observational Medical Outcomes Partnership (OMOP), the Food and Drug Administration's (FDA's) Mini-Sentinel, and the Italian network-the Integration of Content Management Information on the Territory of Patients with Complex Diseases or with Chronic Conditions (MATRICE).
  
  
  RESULTS
  National networks (OMOP, Mini-Sentinel, MATRICE) all adopted shared procedures for local data reorganization. The multinational EU-ADR network needed locally defined procedures to reorganize its heterogeneous data into a common structure. Derivation of new data elements was centrally defined in all networks but the procedure was not shared in EU-ADR. Application of study design was a common and shared procedure in all the case studies. Computer procedures were embodied in different programming languages, including SAS, R, SQL, Java, and C++.
  
  
  CONCLUSIONS
  Using our conceptual framework we found several areas that would benefit from research to identify optimal standards for production of empirical knowledge from existing databases.an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings.
authors.affiliation: Agenzia Regionale di Sanità della Toscana; Erasmus MC University Medical Center.
authors.forename: Rosa
authors.initials: R
authors.lastname: Gini
authors.affiliation: Janssen Research & Development, Epidemiology; Observational Health Data Sciences and Informatics (OHDSI).
authors.forename: Martijn
authors.initials: M
authors.lastname: Schuemie
authors.affiliation: Harvard Medical School.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brown
authors.affiliation: Janssen Research & Development, Epidemiology; Observational Health Data Sciences and Informatics (OHDSI).
authors.forename: Patrick
authors.initials: P
authors.lastname: Ryan
authors.affiliation: Università degli Studi di Milano, Dipartimento di Informatica.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Vacchi
authors.affiliation: Consiglio Nazionale delle Ricerche, Istituto di Scienza e Tecnologie dell'Informazione.
authors.forename: Massimo
authors.initials: M
authors.lastname: Coppola
authors.affiliation: Università degli Studi di Milano, Dipartimento di Informatica.
authors.forename: Walter
authors.initials: W
authors.lastname: Cazzola
authors.affiliation: Erasmus MC University Medical Center.
authors.forename: Preciosa
authors.initials: P
authors.lastname: Coloma
authors.affiliation: Agenzia Regionale di Sanità della Toscana.
authors.forename: Roberto
authors.initials: R
authors.lastname: Berni
authors.affiliation: Université Bordeaux, LESIM - ISPED.
authors.forename: Gayo
authors.initials: G
authors.lastname: Diallo
authors.affiliation: José Luis Oliveira University of Aveiro, DETI/IEETA.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Oliveira
authors.affiliation: Harvard Medical School.
authors.forename: Paul
authors.initials: P
authors.lastname: Avillach
authors.affiliation: Erasmus MC University Medical Center.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trifirò
authors.affiliation: Erasmus MC University Medical Center.
authors.forename: Peter
authors.initials: P
authors.lastname: Rijnbeek
authors.affiliation: Agenzia Nazionale per i Servizi Sanitari Regionali.
authors.forename: Mariadonata
authors.initials: M
authors.lastname: Bellentani
authors.affiliation: Erasmus MC University Medical Center.
authors.forename: Johan
authors.initials: J
authors.lastname: van Der Lei
authors.affiliation: University of Amsterdam, Academic Medical Center.
authors.forename: Niek
authors.initials: N
authors.lastname: Klazinga
authors.affiliation: Erasmus MC University Medical Center.
authors.forename: Miriam
authors.initials: M
authors.lastname: Sturkenboom
keywords: Data management; Data reuse; Electronic Health Records; Health Services Research; Pharmacoepidemiology; Research networks