Overview of Dr. Knaik's Epic Cosmos Presentation

Feb 16, 2025

Lecture Notes: Introduction to Dr. Lindsay Knaik and Epic Cosmos

Speaker Introduction

  • Dr. Lindsay Knaik
    • Visiting from University of Iowa
    • Professor of metrics and associate CMIO at Stead Family Children's Hospital
    • Background in biomedical engineering and medical education in Iowa
    • Residency in theatrics at Baylor, fellowship in neonatology at Vanderbilt
    • Involved in research on targeted ventilation in neonatal care

Epic Cosmos Overview

  • Cosmos
    • Research-related sharing network
    • Large de-identified database of clinical EHR information
    • Over 203 million patients and billions of encounters
    • Fast query processing, though some waiting might be needed
    • Diverse data set: labs, medications, social determinants of health

Benefits and Challenges of Cosmos

  • Large-scale data similar to U.S. Census
  • Longitudinal data available but with caveats (patient movement)
  • Need for reliable data as Cosmos is still developing
  • User access requires Epic Institution membership and training

Research and Usage

  • Example Study: Neonatal Hypertension

    • Used slicer-dicer to filter data
    • Challenges with data mapping (e.g., NICU vs. PICU)
    • Validated cohort using Epic’s slicer-dicer
    • Explored using SQL for deeper data analysis, encountered limitations

  • Cosmos Slicer-Dicer

    • Allows for initial aggregate analysis
    • Cosmos dashboard and data science tools available
    • Virtual machine access for collaboration and secure data handling

Collaboration and Feedback

  • Epic open to user feedback for improvement
  • Enhancements in data categories (e.g., prematurity subcategories)
  • Research collaboration opportunities (e.g., maternal-infant cohort work)

Practical Insights and Future Directions

  • Epic’s Sidekick (large language models) for query assistance
  • Limitations in Sidekick’s current effectiveness
  • Importance of clinician oversight in query validation

Funding and Publication

  • Cosmos use is free unless research is funded, Epic requests a contribution
  • Concerns about Epic’s research team publishing in similar domains

Final Thoughts

  • Potential for Cosmos to streamline large-scale research
  • Need for continuous validation and understanding of data limits
  • Importance of multidisciplinary collaboration in data usage

This summary encapsulates the major points and discussions in Dr. Lindsay Knaik's presentation on Epic Cosmos, detailing the database's capabilities, research potential, and practical considerations for users.