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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We introduce a multi-institutional data harvesting (MIDH) method for longitudinal observation of medical imaging utilization and reporting. By tracking<jats:italic>both<\/jats:italic>large-scale utilization<jats:italic>and<\/jats:italic>clinical imaging results data, the MIDH approach is targeted at measuring surrogates for important disease-related observational quantities over time. To quantitatively investigate its clinical applicability, we performed a retrospective multi-institutional study encompassing 13 healthcare systems throughout the United States before and after the 2020 COVID-19 pandemic. Using repurposed software infrastructure of a commercial AI-based image analysis service, we harvested data on medical imaging service requests and radiology reports for 40,037 computed tomography pulmonary angiograms (CTPA) to evaluate for pulmonary embolism (PE). Specifically, we compared two 70-day observational periods, namely (i) a pre-pandemic control period from 11\/25\/2019 through 2\/2\/2020, and (ii) a period during the early COVID-19 pandemic from 3\/8\/2020 through 5\/16\/2020. Natural language processing (NLP) on final radiology reports served as the ground truth for identifying positive PE cases, where we found an NLP accuracy of 98% for classifying radiology reports as positive or negative for PE based on a manual review of 2,400 radiology reports. Fewer CTPA exams were performed during the early COVID-19 pandemic than during the pre-pandemic period (9806 vs. 12,106). However, the PE positivity rate was significantly higher (11.6 vs. 9.9%,<jats:italic>p<\/jats:italic>\u2009&lt;\u200910<jats:sup>\u22124<\/jats:sup>) with an excess of 92 PE cases during the early COVID-19 outbreak, i.e., ~1.3 daily PE cases more than statistically expected. Our results suggest that MIDH can contribute value as an exploratory tool, aiming at a better understanding of pandemic-related effects on healthcare.<\/jats:p>","DOI":"10.1038\/s41746-022-00653-2","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T08:03:09Z","timestamp":1660896189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Early-stage COVID-19 pandemic observations on pulmonary embolism using nationwide multi-institutional data harvesting"],"prefix":"10.1038","volume":"5","author":[{"given":"Axel","family":"Wism\u00fcller","sequence":"first","affiliation":[]},{"given":"Adora M.","family":"DSouza","sequence":"additional","affiliation":[]},{"given":"Anas Z.","family":"Abidin","sequence":"additional","affiliation":[]},{"given":"M.","family":"Ali Vosoughi","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-4665","authenticated-orcid":false,"given":"Christopher","family":"Gange","sequence":"additional","affiliation":[]},{"given":"Isabel O.","family":"Cortopassi","sequence":"additional","affiliation":[]},{"given":"Gracijela","family":"Bozovic","sequence":"additional","affiliation":[]},{"given":"Alexander A.","family":"Bankier","sequence":"additional","affiliation":[]},{"given":"Kiran","family":"Batra","sequence":"additional","affiliation":[]},{"given":"Yosef","family":"Chodakiewitz","sequence":"additional","affiliation":[]},{"given":"Yin","family":"Xi","sequence":"additional","affiliation":[]},{"given":"Christopher T.","family":"Whitlow","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7459-0854","authenticated-orcid":false,"given":"Janardhana","family":"Ponnatapura","sequence":"additional","affiliation":[]},{"given":"Gary J.","family":"Wendt","sequence":"additional","affiliation":[]},{"given":"Eric P.","family":"Weinberg","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3596-0787","authenticated-orcid":false,"given":"Larry","family":"Stockmaster","sequence":"additional","affiliation":[]},{"given":"David A.","family":"Shrier","sequence":"additional","affiliation":[]},{"given":"Min Chul","family":"Shin","sequence":"additional","affiliation":[]},{"given":"Roshan","family":"Modi","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2790-8946","authenticated-orcid":false,"given":"Hao Steven","family":"Lo","sequence":"additional","affiliation":[]},{"given":"Seth","family":"Kligerman","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0029-8906","authenticated-orcid":false,"given":"Aws","family":"Hamid","sequence":"additional","affiliation":[]},{"given":"Lewis D.","family":"Hahn","sequence":"additional","affiliation":[]},{"given":"Glenn M.","family":"Garcia","sequence":"additional","affiliation":[]},{"given":"Jonathan H.","family":"Chung","sequence":"additional","affiliation":[]},{"given":"Talissa","family":"Altes","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2552-7362","authenticated-orcid":false,"given":"Suhny","family":"Abbara","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3807-0261","authenticated-orcid":false,"given":"Anna S.","family":"Bader","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"653_CR1","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1016\/j.jacr.2020.07.001","volume":"17","author":"AM Norbash","year":"2020","unstructured":"Norbash, A. 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Aidoc provided technical infrastructure support for data collection and analysis, but was not involved in the research otherwise. A.A.B. is a consultant for Olympus Medicine and Daiichi Pharmaceuticals. Y.C. is paid for consulting services for Aidoc on projects unrelated to the present research work and owns stock options in Aidoc. C.T.W. is a paid consultant for the Biogen MRI Protocol Advisory Board. S.A. receives royalties for authorship from Elsevier and is a member of the Board of Directors for SCCT (Society of Cardiovascular Computed Tomography). The remaining authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"120"}}