Building a Longitudinal National Integrated Cardiovascular Database　― Lessons Learnt From SingCLOUD ―

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  Figure 1.. Database architecture. The Business Research Analytics and Information Network (BRAIN) system works on a federated data grid approach to automate query execution to different data sources. The results from the query are then subsequently linked and harmonized before anonymizing the data for analysis by the users.

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  Figure 2.. CONSORT diagram showing how Singapore Cardiovascular Longitudinal Outcomes Database (SingCLOUD) was used to generate the myocardial infarction (MI) and the MI with percutaneous coronary intervention (PCI) cohorts. AMI, acute myocardial infarction; CABG, coronary artery bypass grafting; CAD, coronary artery disease; IHD, ischemic heart disease; NEHR, National Electronic Health Record System; SCDB, Singapore Cardiac Data Bank. 1Analysis was focused on 2012–2014 patients because the data were relatively more complete and had been audited internally. 2Removed patients who died ≤14 days after index MI. 3Demographic information such as gender, age, and ethnicity; the cohort has an overlap of 4,844 patients with SCDB records.

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  Figure 3.. Schematic diagram of how Singapore Cardiovascular Longitudinal Outcomes Database (SingCLOUD) adds to existing databases. ED, emergency department; HF, heart failure; LDL, low-density lipoprotein; MI, myocardial infarction.

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  Figure 4.. Initial audit for data completeness and accuracy.