Utilizing real-world data to inform healthcare decision making during the COVID-19 pandemic: an interview with Daniel Prieto-Alhambra

In this feature, Daniel Prieto-Alhambra (University of Oxford; UK) discusses his involvement in the recent virtual study-a-thon hosted by the Observational Health Data Sciences and Informatics (OHDSI) community, as well as the relevance of real-world evidence to the fight against COVID-19.

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The Observational Health Data Sciences and Informatics (OHDSI) international community recently hosted a virtual 'study-a-thon', during which various global, observational studies were designed and initiated to generate immediate real-world evidence on prioritized questions surrounding COVID-19.

Daniel Prieto-Alhambra (University of Oxford; UK) was one of the academic leads for this effort and, in this interview, discusses the importance of the initiative and the relevance of real-world evidence to the fight against COVID-19 and the evaluation of the safety of potential treatment strategies


Please could you introduce yourself?

I am a Professor of pharmaco- and device epidemiology at the University of Oxford.

…we realized we could make a difference by leveraging from the international community driven by OHDSI, and so we did.”

What was the driving force behind hosting the OHDSI virtual study-a-thon?

We were due to host the OHDSI annual European symposium in Oxford this year, however, the event had to be cancelled due to the coronavirus crisis. I, alongside the symposium committee, decided to organize and host this virtual study-a-thon instead; we realized we could make a difference by leveraging from the international community driven by OHDSI, and so we did.


Why are such global, collaborative initiatives important for ensuring large amounts of representative data are collected and disseminated during the current pandemic?

As this pandemic moves rapidly around the globe, we need to coordinate action, learn from those who have been there first and leverage any knowledge we can learn, before it is too late. The generosity of the OHDSI community partners makes this possible at an unprecedented pace.


What role can real-world evidence play in informing healthcare decision making during the COVID-19 outbreak?

There are three areas where real world evidence will be useful: 1) characterizing COVID-19 patient symptoms, care needs and outcomes to plan care delivery, 2) predicting who is most at risk of hospital admission and of poor outcomes, so that we can target and inform management, and 3) rapidly and accurately studying the safety profile of potential drug targets, as well as, in the short term, assessing their real-world effectiveness once data are available.

One key challenge in the current crisis has to do with potential issues with the quality of the data recorded in the midst of extremely busy clinics.”

What are some of the challenges and limitations associated with conducting real-world evidence studies?

Real-world data are collected in routine clinical practice settings; despite many strengths associated with these data – such as their representativeness, the speed of data collection, external validity – challenges associated with their use remain. One key challenge in the current crisis has to do with potential issues with the quality of the data recorded in the midst of extremely busy clinics.

The OHDSI community is putting a lot of work and effort into defining and validating COVID-19 phenotypes, to identify and mitigate any potential glitches in the data.


How may real-world data be used to evaluate the feasibility of repurposing certain established drugs for the treatment/management of COVID-19?

We can deliver very solid and accurate reports on the safety of different target drugs being investigated for use as COVID-19 treatments using retrospective (existing) data. In fact, we have recently submitted our first manuscript, on the safety of hydroxychloroquine – both when administered alone and in combination with azithromycin – in more than 950,000 patients.

We can deliver very solid and accurate reports on the safety of different target drugs being investigated for use as COVID-19 treatments using retrospective (existing) data.”

In addition, by utilizing newly generated real-world data, we will also be able to look at the clinical effectiveness of the different drug targets as used in actual practice for the treatment of COVID-19.


What are some further studies that you are currently planning and executing?

We are currently planning studies on the characterization of pregnant women and children affected by COVID-19. We are also designing a pipeline for rapid studies on the safety and anti-COVID effectiveness of any potential therapeutic targets – more will come as our community rallies together to battle this disease.


The opinions expressed in this feature are those of the interviewee/author and do not necessarily reflect the views of The Evidence Base® or Future Science Group.

 

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