“Regional Differences in Thrombectomy Rates” have been reported by clinicians from the MIRACUM sites, based on the secondary use of anonymized billing data. As a first research question to be tackled with the MIRACUM DIC infrastructure already during the BMBF MI-I conceptual phase neurologists and neuroradiologists from the University Hospital Freiburg triggered the question, how the international recommendation (2015) to treat acute ischemic stroke with mechanical thrombectomy, in addition to intravenous thrombolysis within 4.5 hours when eligible, has been implemented in the eight MIRACUM university hospitals since then. Statistical analysis procedures for this purpose have been defined, implemented and tested locally at one MIRACUM site and were afterwards distributed to all MIRACUM sites. At all MIRACUM sites the DIC 0.9 release included data elements of the MI-I core dataset basic modules person, demographics, encounters, diagnosis and procedures. Thus ICD-codes were used for cohort identification and R-based analysis included the respective procedure codes for treatment comparisons. The observed increase of thrombectomy rates and drip-and-ship procedures without a significant difference between weekdays and weekends or patients of different ages is substantiating a rapid implementation of the stroke guidelines within the analyzed neurovascular centers. The research illustrated how the first i2b2-based prototype of the MIRACUM Data Integration Center already contributes to health services research in Germany.
Haverkamp C, Ganslandt T, Horki P, Boeker M, Dörfler A, Schwab S, Berkefeld J, Pfeilschifter W, Niesen WD, Egger K, Kaps M, Brockmann MA, Neumaier-Probst E, Szabo K, Skalej M, Bien S, Best C, Prokosch HU, Urbach H. Regional Differences in Thrombectomy Rates : Secondary use of Billing Codes in the MIRACUM (Medical Informatics for Research and Care in University Medicine) Consortium. Clin Neuroradiol. 2018 Jan 8. doi: 10.1007/s00062-017-0656-y. [Epub ahead of print] PubMed PMID: 29313057.