Comparative Outcomes Management with Electronic Data Technologies (COMET)
The goal of this project is to develop a new electronic data network infrastructure that will prospectively enable access to and the sharing of clinical and research data between four sleep medicine Clinical Centers (CCs) across the United States. The development of this new, broad, scalable, and sustainable electronic data network will enable the collection of longitudinal data content (both digital and physical) by each of the four CCs. The electronic network infrastructure developed through COMET will link the prospective information collected from a comparative effectiveness trial via multiple CCs, diverse patient and research participant populations, different patient comorbidities and disease severities, various equipment and test types, and several patient visits. Ultimately, the project will design a single-point access Sleep Research Application that can be sustained by hosting subsequent prospective cohort research projects using a template-based approach. Initial data in the network will be collected from a pilot comparative effectiveness project comparing sleep apnea devices and treatments. For more information, visit comet.stanford.edu.
- Develop a new electronic data network to enable sharing and access across a network of clinical centers;
- Utilize an informatics platform that integrates data across the clinical centers and builds domain-specific taxonomies, meta data, and content types across the network;
- Utilize a comprehensive, web-based questionnaire to improve patient care and support ongoing research efforts in the field of sleep medicine; and
- Integrate various diverse patient-centered data sources, including a variety of device-generated data.
Primary Research Aims
To conduct a randomized two-arm CER trial to compare two treatments in patients with obstructive sleep apnea: Positive airway pressure (PAP) and Oral Appliances.
Geographic scope type
Locations of Focus
Main sites are located in: Stanford, CA; Philadelphia, PA; Madison, WI; and Boston, MA.
Population Network Size
The estimated size of the network is 20,000 patients annually. The study population size for the comparative effectiveness trial is 190 participants.
The COMET informatics platform is based on centralized servers and a federated/distributed network of servers located at various Sleep Alliance clinical centers. The centralized servers consist of three hardware platforms which house Microsoft SQL Server database server, Microsoft SharePoint content management system, Microsoft Web application server, two ftp servers, and a Linux server with a MySQL database server. Servers located at Sleep Alliance clinical centers consist of Linux servers with a MySQL database server and a web application server and various file systems. Internetworking communications includes federated query, file transfer, automated email notification, and database reporting systems.
Stanford Sleep Medicine Center (Lead Site); Academic Alliance for Sleep Research (AASR); participating institutions Stanford University, University of Pennsylvania, University of Wisconsin- Madison, Harvard University); Microflow DBMS, Inc. (Informatics Consultants)
CER/PCOR Study Priority Populations
Minority groups, Women, The elderly, Cardiovascular disease, including stroke and hypertension (Heart and blood vessel conditions), Obesity, Pulmonary disease/asthma (Breathing conditions)
Outcome(s) of Interest
Mean nocturnal blood pressure; Flow-mediated vasodilatation (FMD) of the brachial artery; sleep-disordered breathing, sleepiness, mood, and quality of life; cost-effectiveness of PAP and oral appliances; cardiovascular biomarkers; genetic polymorphisms
Acknowledgement of Funders
This project is supported by grant number 1R01HS019738 from the Agency for Healthcare Research and Quality, and is one of the ARRA-funded PROSPECT (Prospective Outcome Systems using Patient-specific Electronic data to Compare Tests and therapies) studies.