University of Texas Health Science Center Houston

Clinical and research data are increasingly collected and aggregated in clinical data warehouses (CDWs). Access to these data is subject to local, state and national regulations. For multiple reasons, institutions differ in how they interpret and apply these regulations. Sometimes, inter-institutional differences are unavoidable, such as when regulations clearly require specific practices. However

There has been a true revolution in cancer treatment. Numerous genetic alterations are being targeted using new therapies with the potential for improved, less toxic – often durable - outcomes in advanced cancer. Response rates are 3-5% for unmatched treatment with new tyrosine kinases and other similar agents whereas a “high value” alteration can result in response rates of 30-50% for actionable

Learning healthcare (LHC) incorporates learning seamlessly into everyday patient care and is crucial to rapidly advancing patient outcomes and ultimately population health. Observational studies are valuable in generating new hypotheses and identifying highly effective therapies (resulting in a published relative risk for adverse outcome <0.10 compared to placebo or usual care). However, the great