目的:总结150,000次检查的SCMR注册状态。
背景:心血管磁共振(CMR)越来越多地用于评估不断扩大的心血管疾病。SCMRRegistry是支持心血管研究的现实世界临床数据的中央存储库。包括与结果有关的那些,质量改进,和机器学习。SCMR注册表建立在符合法规的基础上,基于云的基础设施,可容纳可搜索的内容以及医学数字成像和通信(DICOM)图像。
方法:数据安全的过程,数据提交,并概述了研究访问。我们询问了书记官处,并提供了其内容摘要。
结果:数据来自美国20个站点的154,458次CMR扫描,包含299,622,066张总图像(约100TB的存储空间)。人类受试者的平均年龄为58岁(范围为1个月至>90岁),44%是女性,72%白种人,死亡率为8%。最常见的适应症是心肌病(27%),最常用的当前程序术语(CPT)代码为75561(35%).2015年后,基于大环钆的造影剂占造影剂利用率的89%。在99%的扫描中进行了短轴扫描,短轴LGE在66%,和30%的应力灌注序列。死亡率数据显示左心室射血分数(LVEF)<35%的患者死亡率增加,壁运动异常的存在,应力灌注缺陷,和梗塞晚期钆增强(LGE),与没有这些标记的人相比。有456,678个患者年的全因死亡率随访,中位随访时间为3.6年。
结论:SCMRRegistry的愿景是通过协作努力,通过为中心提供一种网络机制,安全地上传去识别的数据和图像进行研究,促进CMR的循证利用。教育,和质量控制。注册表量化随时间变化的实践,并支持对预后效用的大规模现实世界多中心观察研究。
结论:SCMRRegistry是一个符合监管标准的基于云的中央存储库,用于多中心心血管研究的真实世界临床数据和DICOM图像。包括基于结果的数据。该注册表包含299,622,066个DICOM图像和456,678个患者年随访。来自美国20个地点的154,458次CMR扫描的数据显示,2015年后,心肌病是最常见的适应症,大环钆造影剂利用率为89%。总死亡率为8%,LVEF<35%的患者发病率较高,异常壁运动,缺血存在,或梗塞部位。登记处旨在通过合作努力促进基于证据的CMR利用,以积极影响心血管结果。
OBJECTIVE: To summarize the status of the SCMR Registry at 150,000 exams.
BACKGROUND: Cardiovascular magnetic resonance (CMR) is increasingly utilized to evaluate expanding cardiovascular conditions. The SCMR Registry is a central repository for real-world clinical data to support cardiovascular research, including those relating to outcomes, quality improvement, and machine learning. The SCMR Registry is built on a regulatory-compliant, cloud-based infrastructure that houses searchable content and Digital Imaging and Communications in Medicine (DICOM) images.
METHODS: The processes for data security, data submission, and research access are outlined. We interrogated the Registry and present a summary of its contents.
RESULTS: Data were compiled from 154,458 CMR scans across 20 United States sites, containing 299,622,066 total images (~100 terabytes of storage). The human subjects had an average age of 58 years (range 1 month to >90 years old), were 44% female, 72% Caucasian, and had a mortality rate of 8%. The most common indication was cardiomyopathy (27%), and most frequently used current procedural terminology (CPT) code was 75561 (35%). Macrocyclic gadolinium-based contrast agents represented 89% of contrast utilization after 2015. Short-axis cines were performed in 99% of scans, short-axis LGE in 66%, and stress perfusion sequences in 30%. Mortality data demonstrated increased mortality in patients with left ventricular ejection fraction (LVEF) < 35%, the presence of wall motion abnormalities, stress perfusion defects, and infarct late gadolinium enhancement (LGE), compared to those without these markers. There were 456,678 patient-years of all-cause mortality follow-up, with a median follow-up time of 3.6 years.
CONCLUSIONS: The vision of the SCMR Registry is to promote evidence-based utilization of CMR through a collaborative effort by providing a web mechanism for centers to securely upload de-identified data and images for research, education, and quality control. The Registry quantifies changing practice over time and supports large-scale real-world multicenter observational studies of prognostic utility.
CONCLUSIONS: The SCMR Registry is a central regulatory-compliant cloud-based repository for real-world clinical data and DICOM images for multicenter cardiovascular research, including outcomes-based data. The Registry contains 299,622,066 DICOM images and 456,678 patient-years follow-up. Data compiled from 154,458 CMR scans across 20 US sites demonstrated cardiomyopathy as the most common indication and 89% macrocyclic gadolinium contrast utilization after 2015. There was an overall mortality rate of 8%, with higher rates in those with LVEF<35%, abnormal wall motion, ischemia presence, or infarct LGE. The Registry aims to promote evidence-based CMR utilization through a collaborative effort to positively impact cardiovascular outcomes.