CTSA Biomedical Informatics at Yale University

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CTSA Biomedical Informatics at Yale University

• Perry L. Miller, MD, PhD
• Director, Center for Medical Informatics
• Yale University School of Medicine
• December 7, 2006

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Yale Center for Medical Informatics (YCMI)

• Established in 1991 - one of three formal
  academic centers within the School of Medicine
• Staff - 6 teaching faculty (professors)
  3 affiliated Pathology Informatics faculty - 5
  research faculty (research scientists) - gt25
  other staff members

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The Spectrum of Biomedical Informatics Activities
at the YCMI

• Clinical informatics
• - Informatics support of clinical research
  (Yales GCRC/CTSA,
• Yale Cancer Center, other groups at
  Yale and elsewhere)
• - Informatics support of cancer genetics
  pharmacogenetics
• (two national NIH-supported clinical
  research networks)
• - Computer-based clinical decision support
• - Electronic patient record system RD
• Genomic/proteomic informatics
• - Yale Center for Genomics and Proteomics
  (Mike Snyder)
• - Center of Excellence in Genome Sciences
  (Mike Snyder)
• - Population genetics (Ken Kidd)
• - Yale Microarray Database - YMD (Keck
  Center, Genetics, Biology)
• - Yale Protein Expression Database - YPED
  (Keck Center)
• Neuroinformatics (Gordon Shepherd)
• - Informatics as part of the national Human
  Brain Project
• - Including molecular modeling and neuronal
  modeling

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YCMI Teaching and Training

• Biomedical informatics research training
  supported by the National Library of Medicine
  since 1987, and at our VA starting this year
• Yales interdepartmental PhD program in
  Computational Biology and Bioinformatics

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Collaborative Biomedical Research

• YCMI faculty direct or co-direct the Informatics
  Cores of many research initiatives, including -
  Yale Cancer Center - Yales General Clinical
  Research Center (and CTSA) - Yale Center for
  Genomics and Proteomics - Yales NIH Center of
  Excellence in Genome Science - Yale/NHLBI
  Proteomics Center, Yale/NIDA Neuro-
  proteomics Center, Neuroscience Microarray
  Consortium - NSF-supported Allele Frequency
  Database
• A major advantage of having all these cores based
  in the YCMI is that they can be much more easily
  integrated and coordinated.
• YCMI faculty collaborate with well over 50
  faculty in many different departments.

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Collaborative Translational ResearchExample
Research Areas

• Profs. Josephine Hoh, Arya Mani, Hongyu Zhao,
  Perry Miller Exploring the use of biological
  pathway information to assist in the
  interpretation of high density SNP microarray
  chip data, looking for genes associated with
  disease
• Profs. Paul Lizardi, Hongyu Zhao, Michael
  Krauthammer, David Tuck, Perry Miller Using
  specially designed microarray chips to analyze
  genome-wide patterns of methylation in patients
  with cancer.

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Overview of Yales CTSABiomedical Informatics
Infrastructure
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Building an Institutional Informatics
Infrastructure to Support Clinical and
Translational Science
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Building an Institutional Informatics
Infrastructure to Support Clinical and
Translational Science (continued)
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CTSA Informatics Infrastructure An Example
Trial/DB Yales multi-disciplinary,
Web-accessible database for clinical trials and
clinical and translational research
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Trial/DB History and Current Status

• We initially tested a commercial product
  (Oracle Clinical) on a trial basis.
• 1997 Trial/DB in pilot use in Yale Cancer
  Center.
• 1998 Trial/DB started use in NCIs Cancer
  Genetics Network (CGN). 
• 1999 Web interface for data entry.
• 2000 Trial/DB started use in GCRC at Yale.
• Now Trial/DB has been used for over 70 studies,
  including many multi-site studies, in clinical
  areas that include oncology, endocrine,
  psychiatry, other clinical research.

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Trial/DB Key Features

• Data-input screens (CRFs) are composed
  automatically from a library of re-usable data
  items.
• Web-based data entry/retrieval greatly
  facilitates use by multi-site studies.
• Features to improve data quality and data
  collection monitoring - data entry checks,
  validation, computed fields - calendar for
  reminders, schedules, tracking - reports to
  monitor data collection process
• Automated import of electronic data such as
  laboratory data.
• A range of multi-level, advanced security
  features.

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Potential National CTSA Activities

• Joint development of standards
• Sharing of, and/or joint development of,
  advanced informatics infrastructure
• Help articulate institutional models of how
  Biomedical Informatics is best structured in an
  academic medical center in general (including the
  need to promote and enable clinical and
  translational research)