Researchers at Cleveland Clinic have discovered a relationship between IBD and non-alcoholic liver disease, postulating that immune factors are involved in both the intestinal and liver lesions (see: Studies Reveal Heightened Liver Disease Rates in IBD Patients Immune-mediated factors may be involved). Below is an excerpt from the article but make note of the reference to the use of Explorsys, a research tool owned by IBM:
...Cleveland Clinic researchers and their collaborators have found that patients with inflammatory bowel disease (IBD) experience higher rates of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis and nonalcoholic cirrhosis compared to the general U.S. population in two nationally representative epidemiological studies....The results indicate that the presence of IBD conveys increased risk of comorbid liver disease, although the precise relationship and etiology remain unknown....“Fatty liver disease is increasing in prevalence in the United States and we were interested in determining if IBD is a separate risk factor for nonalcoholic fatty liver disease [NAFLD],”....[the author of the study] says. “We know that IBD has been associated with primary sclerosing cholangitis, and that many of the medications we prescribe affect the liver.” However, he adds, “the contribution of IBD to NAFLD is not known – and we hypothesize may be an underrecognized extra-intestinal manifestation of IBD.”....
[He and his] colleagues studied diagnosis codes in Explorsys...electronic medical records. This commercial database covers 26 major integrated healthcare systems nationwide. From more than 62 million patients, they identified 159,290 people diagnosed with Crohn’s disease (CD) and 125,380 diagnosed with ulcerative colitis (UC) between 1999 and 2018. Next, the researchers looked for people with newly diagnosed NAFLD, nonalcoholic steatohepatitis (NASH) or nonalcoholic cirrhosis (NC) more than 30 days following their CD diagnosis.
A couple of points jumped out of this article for me, the first of which was that IBD may have a relationship to nonalcoholic fatty liver disease (NAFLD) (see: Immune and inflammatory pathways in NASH). The second was the the researchers made use of the Explorsys "commercial" database gathered from 26 major integrated health systems and including 62 million patients. Explorsys was acquired by IBM in 2009 from Cleveland Clinic (see: IBM Acquires Explorys to Accelerate Cognitive Insights for Health and Wellness). The company had been formed in 2009 by Cleveland Clinic Innovations (see: Cleveland Clinic Innovations creates thriving companies out of research). Explorsys is described in the following way on its web landing page: "Providing a secure, cloud-based platform, longitudinal EHR data, and analytic tools to help providers and life sciences companies find new connections among previously siloed healthcare data." Here's another quote pertaining to the Explorsys Data Lake (see: The IBM Explorys Platform):
The IBM Explorys Data Lake is a staging and storage repository that holds a vast amount of raw data in its native format until it is needed. Each data element is assigned a unique identifier and tagged with a set of metadata tags. When a clinical or business question arises, the IBM Explorys Data Lake can be queried for relevant data that can be later added to combined data sets.
I have been aware for some time that Big Tech companies like IBM through its Watson division and Apple were gaining access to large health system EHR databases (see: IBM Buys Merge Healthcare; Integrates Watson into CAD Services; Cleveland Clinic and Apple Make EHR Data More Broadly Accessible via iPhones). However, I was not aware previously of the existence of Explorsys. I want to ponder some of the implications of a for-profit company controlling a large medical research database and hope to blog on this topic later. If any readers of Lab Soft News have opinions on this question, I would welcome their input as comments to this blog note.
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