Harnessing OMOP-CDM for multisite collaborations to measure cardiovascular risk factors and cardiovascular disease in the early survivorship period for children, adolescents, and young adults.

Abstract

10009 Background: The Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) is an international effort to leverage data standards to cultivate multi-institutional collaborations and generate reproducible evidence using real-world data. Four institutions mapped their electronic health records data to the OMOP-CDM. Cardiovascular risk factors (CVRFs) and their impact on risk for cardiovascular disease (CVD) among survivors of childhood cancer merit further investigation into cardiotoxicity during the early survivorship period. Methods: Eligible patients from Seattle Children’s with at least one condition contained within the ancestor concept “malignant neoplastic disease” (concept ID 443392) and an index date defined as the initial administration of a medication contained within the ancestor concept “antineoplastic agents” (concept ID 21601387) were included. Clinically computable phenotypes from OMOP-CDM data were constructed in alignment with the Common Terminology Criteria for Adverse Events (version 6.0) for hypertension, diabetes, obesity, and hyperlipidemia within one year of the index date. The primary outcome was CVD, defined as the incidence of cardiomyopathy, heart failure, atrial fibrillation, and ventricular arrhythmias within 1-5 years of the index data. Results: Among 1195 survivors, the incidence rate of any CVD from non-cardiotoxic therapy was 0.11 per 100-person-years (95% Confidence Interval 0.04-0.25), compared to 0.43 (95% CI 0.25-0.71) and 1.6 (95% CI 0.08-7.88) for survivors treated with cardiotoxic therapy and cardiotoxic therapy plus targeted or immunotherapy, respectively. Validation of results and sharing of coding for multi-site meta-analysis is ongoing. Conclusions: OMOP-CDM represents a feasible approach to explore CVRFs and CVD in the early survivorship period among contemporary cohorts treated with traditional cardiotoxic chemotherapy, targeted therapy, and immunotherapy. CVD and CVRF among survivors. Non-cardiotoxic ChemotherapyN=677 Cardiotoxic chemotherapyN=493 Cardiotoxic and Targeted ImmunotherapyN=25 Age (in years) 6.6 (5.1) 8.6 (5.3) 9.4 (4.9) Cancer Type CNS 240 (35.5%) 0 (0.0%) 0 (0.0%) Hematologic 267 (39.4%) 285 (57.8%) 23 (92.0%) Solid Tumor 160 (23.6%) 208 (42.2%) 2 (8.0%) Sex (Female) 310 (45.8%) 243 (49.3%) 10 (40.0%) Race Asian 54 (8.0%) 36 (7.3%) 2 (8.0%) Black/African American 22 (3.2%) 13 (2.6%) 0 (0.0%) Hispanic 131 (19.4%) 101 (20.5%) 4 (16.0%) White 351 (51.8%) 259 (52.5%) 14 (56.0%) Other or Unknown 119 (17.6%) 84 (17.0%) 5 (20.0%) CVRFs (<1 year) Hypertension 111 (16.4%) 103 (20.9%) 5 (20.0%) Diabetes 100 (14.8%) 78 (15.8%) 8 (32.0%) Hyperlipidemia 87 (12.9%) 61 (12.4%) 8 (32.0%) Obesity 214 (31.6%) 143 (29.0%) 4 (16.0%) CVD (1-5 years) Any 2 (0.3%) 12 (2.4%) 1 (4.0%)