Demonstration of Interoperability Between MIDRC and N3C: A COVID-19 Severity Prediction Use Case

Interoperability between data sources, one of the FAIR (Findability, Accessibility, Interoperability, and Reusability) principles for scientific data management, can enable multi-modality research. The purpose of our study was to investigate the potential for interoperability between an imaging resource, the Medical Imaging and Data Resource Center (MIDRC), and a clinical record resource, the National COVID Cohort Collaborative (N3C). The use case was the prediction of COVID-19 severity, defined as evidence for invasive ventilatory support, extracorporeal membrane oxygenation, death, or discharge to hospice in the N3C clinical record. Patient-level matching between MIDRC and N3C was identified using Privacy Preserving Record Linking via an honest broker. We identified positive COVID-19 tests and chest radiograph procedures in N3C and used the interval between them to identify images with matching intervals in MIDRC. Of the 236 patients (306 unique images) meeting initial inclusion criteria in MIDRC, 117 patients (and 139 unique images) remained after date interval matching between repositories and exclusion of patients with multiple potential matches. The Charlson Comorbidity Index (CCI) and the minimum mean arterial pressure (MAP) on the day of the chest radiograph were used as clinical indicators. The AUC in the task of predicting severe COVID-19 was evaluated using the computer-extracted imaging index alone (MIDRC), clinical indicators alone (N3C), and both together. Our model combining imaging and clinical indicators (CCI over 2 and MAP below 70) to predict severe COVID had an AUC of 0.73 (95% CI 0.62-0.84), and the models including imaging or clinical indicators alone were 0.67 (95% CI 0.56-0.79) and 0.69 (95% CI 0.59-0.80), respectively. This study highlights the potential for cross-platform data sharing to facilitate future multi-modality research and broader collaborative studies.