As a relatively new path of pathology, COVID-19 brings much uncertainty about its effects on the safety and efficiency of drug treatments. Ever since the pandemic unfolded, researchers across the nation quickly needed to answer challenging questions.
Marc Suchard, IDRE Board member, is one such biostatistician who strives to answer these inquiries. We interviewed him regarding his recent study and how COVID-19 has altered the landscape of international drug safety research.
Hypertension medication and COVID-19 susceptibility
Back in June, he and a group of international researchers released a study on ACE inhibitors and ARBs. Used by millions of Americans and billions around the world, they are some of the most commonly prescribed anti-hypertensives. Cardiovascular health is one of the major leading causes of death and a major determinant of COVID-19.
Initially, the major concern became whether or not the patients are at undue risk of infection and complication. Both the virus and these specific classes of drugs use the same cellular protein for cell entry. However, the paper concluded that popular medication does not put patients at greater risk for COVID-19.
The virtual multi-national open science cohort observational study method explained
Moreover, what’s equally fascinating was the length of time, and the research production process. This project grew out of an 88-hour virtual study-a-thon and utilized a multi-national open observation cohort study method.
Hosted by the Observational Health Data Sciences and Informatics community (or OHDSI, pronounced “Odyssey”), the virtual conference made a meaningful impact on COVID-19 in just short of 4 days.
OHDSI is a global community who volunteers their time and talent to improve healthcare through observational research. As a founding member, Suchard credits this international community as the reason the study was put together.
“We were in a unique position in a community with global patient data, pressing health concern and a unique set of open-source resources that we could capitalize,” Suchard said.
So why did they use observations study instead of controlled randomized trials?
Mainly for the sake of scale, time, and logistics. This method quickly produces very generalizable conclusions. To mitigate the unobserved confounding effect, they gathered electronic health record inputs (EHRs) from a large number of international data custodians.
By coding an extensive hierarchy of medical vocabulary systems on a multi-national scale, they can map different disease specifications from system to system, location to location.
This large scaled and open-source data model overcame the misconception that international standardization of EHRs leads to information loss and mistranslation.
“We built shared open-source resources over the last couple of years that allow individuals to design implement and validate occupational studies for healthcare outcomes,” Suchard explained.
COVID-19’s effect on international remote drug research
Besides its impact on the risk of drug usage, the virus has evolved remote research. From encouraging new research methods, increasing community engagement and a strong motivator, COVID-19 had some unexpected consequences.
Only in the last few years, the development of the international community, and data standardization was even feasible. While the ability to research across multiple data sources is generally very new, there has been a cultural shift in behavior.
Although by nature these international studies have been executed on a remote basis, people are more willing to interact virtually. Now, the acceptance of the new format spans across different time zones.
Likewise, there is also an increase in the number of participants. Suchard observed that a collaboration with Daniel Morales, lead author of this study would have never been possible if their paths hadn’t crossed in the digital space. These endeavors would not be possible without the international collaboration of clinicians, epidemiologists, informaticists, institutions, and more.
Suchard specifically credits the role that IDRE played in looking at the health experiences of over a million individuals. “It’s a very data-rich problem that requires extensive compute resources and IDRE plays an intimate role in providing those compute resources, to execute the studies,” Suchard remarks.
Finally, the virus has lead to an increased motivation to provide data by institutions such as the US Department of Veteran’s Affairs and SIDIAP, a Spanish health research organization and the health authority of Catalonia.
“It’s a data source I’ve been trying to get motivated for years. You know it requires a whole lot of work to get,” Suchard said.
Marc Suchard has been on the 2019 list of the world’s most influential scientific researchers. He is the senior developer of an open-source software program that’s used by more than 1,000 research groups worldwide to understand, on a genomic level, how infectious diseases spread.