bndmr_presentation_english_march2014
TRANSCRIPT
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The French RD Registry
Paul Landais & Rémy ChoquetBNDMR, Montpellier & Paris, France
Istituto Superiore di Sanità, March 5th, 2014
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A National data bank for rare diseases (BNDMR)dedicated to the centres of expertise
The French Data Repository for RD
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BNDMR : objectives
Objectives: Describe the demand for care Describe the offer of care Assess the adequacy of the supply to the demand Identify potentially eligible patients for clinical trials or
cohorts
Means: Implement a national database Supporting a minimum data set Set up an interoperability framework
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Domains, systems, objectives and interoperability
Epidemiology Care Research
Interoperability of systems and data
Databases
Electronic Health Record
Case Report Forms
Public HealthEpidemiology
Clinical trialsCohorts
Patients support of care
Source: BaMaRa 2013
Objectives
Systems
Domains
connectors connectors
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DataWarehouse
Systems
Interoperability
Domains
Infrastructures
BNDMR : National Data Bank for Rare Diseases; BaMaRa: Rare Diseases Database; EHR: Electronic Health Record; MDS : Minimum Data Set ; RaDiCo : Rare Disease Cohorts; SNIIRAM : Information system of the Health Care Insurance; PMSI : Activity based Payment Information System; SAE : Hospitals Annual Statistics ; DRESS : Direction for research, studies, evaluation and statistics of the Ministry of Health; INSEE : National Institute for statistics and economic studies. Source : Landais P, Choquet R, BaMaRa 2014
Epidemiology Care Research
BaMaRaEHR
MDS
RaDiCoconnectors
BNDMR SNIIRAMPMSISAE
DRESSINSEEOther
sources
BNDMR, PNMR2, DGOS
Plan Hôpital Numérique, DGOS,DGS,ARS
RaDiCo, investments for thefuture, INSERM, ANR
Interoperability framework
Interoperability of systems and data
connectors
BNDMR
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The French RD network
131 RD centers of expertise 501 RD centers of competence
54 laboratories for molecular diagnosis
Biological resources centers
12 RD registries
Ongoing research programs: 49 NRA ; 158 PHRC (hospital research
program); 227 clinical trials (106 academic, 121
industrial)
RDCE4
RDCE3
RDCE2
RDCE1
RDCE8
RDCE7
RDCE6
RDCE5
RDCE n+1
RDCE n
RDCE10
RDCE9
RDCE131
RDCE130
RDCE129
RDCE128
Sectors(RD)
I
II
III
n
….
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The French RD networkBNDMR/BaMaRa RaDiCo
Data: Minimum data set
All the patients
Data:Extensive longitudinal follow-up (Phenomics)
Subgroups of patients
t0 t1 t2 t3 t4 t5 t6
t0 t1 t2 t3 t4 t5 t6
t0 t1 t2 t3 t4
t0 t1 t2 t3 t4 t5 t6
t0 t1 t2 t3 t4 t5
Public health Research
RDCE4
RDCE3
RDCE2
RDCE1
RDCE8
RDCE7
RDCE6
RDCE5
RDCE n+1
RDCE n
RDCE10
RDCE9
RDCE131
RDCE130
RDCE129
RDCE128
Sectors(RD)
I
II
III
n
….
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An interoperability framework for RD
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National identifier
The identification of patients in the French health systems is subject to specific restrictions defined by the CNIL (National Committee for Informatics and Freedom).
Proposal for a national rare diseases unique and anonymous.
Generate a unique identifier for RD, according to the regulations in force, in order to reduce the number of duplicates (two IDs for a single patient) and possible collisions (same ID for two different patients).
Such an approach has already been carried out by the GRDR in the USA: the Globally Unique Identifier (GUID).
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Coding information
Definition of a minimum data set (MDS) common to all centers of expertise and for all rare diseases
It enables : Homogenizing data collection Identifying and following the active list of RD patients Accounting for the RD activity performed in a reference
center The minimum data set is standardized and available for
industrial suppliers of informatics solutions (without commercial use).
It is available at the European level.
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The French RD minimum data set
Consent (according to Regulatory recommendations) National anonymous patient Identifier (subject to validation by the
CNIL) Personal information Family information (if applicable) Vital status Care pathway Care activity Medical history Diagnosis Diagnosis confirmation Treatment (orphan drugs) Ante and neonatal course (if applicable) Research Structure of care
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MDS availability
The RD minimum data set is licensed under Creative Commons Attribution - Noncommercial use – Share under the same conditions 3.0 France (and 4.0 international)
For industrial suppliers of informatics solutions, the MDS use is allowed when an interface is also created in the host application to ensure the sending of data to the BNDMR.
Downloadable at http://bndmr.fr
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Flow & data exchange processes
Each center may have multiple databases to collect patients data in the active list.
Information can be divided into various applications: patient record, local, national or international registries, Excel file, paper.
Each database being technically different, the development of connectors with the BNDMR is each time different.
The BNDMR team publishes formats for data exchange enabling to communicate with the national base.
We accompany the reference centers to define the best strategy for implementing the process of exchange between internal applications and the BNDMR.
Security topics concerning patients’ data are discussed with the technical teams.
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An aid for coding RD
Linking Opendata for Rare Diseases
http://lord.bndmr.fr
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Inventory
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Call for RD cohorts
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Acknowledgments
To our collaborators of the BNDMR team: Y Fonjallaz, A de Carrara, M Maaroufi, C Messiaen, JP Necker, C Angin.
To the RaDiCo team: S Amselem, A Clement, J Weinbach. To the members of the network of the 131 RD Centers of
expertise To the members of the BNDMR Steering Committee To the DGOS and the DGS members in charge of the
PNMR2: D Péton-Klein, V Drouvot, P Dosquet To the staff of the clinical research unit of the University
Montpellier 1, EA 2415 and Nîmes university hospital
This program is funded by the French Ministry of Health