Information

Related Research Units

Computational Health Informatics Program

Research Overview

Dr. Natter is leader and Principal Investigator of the Registry Informatics Research and Development Lab (RiR+D) within the Computational Health Informatics Program (CHIP) at Boston Children's Hospital. His research centers broadly on developing and applying clinical informatics and analytics to chronic diseases research in pediatric rheumatic and other autoimmune diseases, with a particular focus on the development, implementation, and provision of multi-source biomedical data repositories enabling multi-site, multi-center collaborative research across investigator-initiated clinical research networks. Over 15 years, as chief architect and PI of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Data Warehouse, established in 2010 under an NIH Grand Opportunities grant and as a former Director of Informatics for CARRA – the largest investigator-led pediatric rheumatic diseases network in North America – he led the design, implementation, data warehousing operations, and data distribution operations of this resource, providing analysis-ready, investigation-specific analytic data sets and analytic assistance to hundreds of investigators. Dr. Natter also led or co-led the regulatory-compliant informatics design, implementation, and operations for multiple other multi-center projects funded by NIH and PCORI, including the NHLBI-funded Pediatric-onset Pulmonary Hypertension Registry biomedical data repository and the PCORI-funded Accessible Research Commons for Health (ARCH) clinical data research network. As PI of an FDA collaborative grant, he led development of a 21 CFR 11-compliant FHIR data warehouse to combine patient-reported outcomes data with other clinical registry data. He is also PI of an NIH-funded effort grant to create a set of consensus-based common data elements for Juvenile Idiopathic Arthritis (JIA). In collaboration with CHIP colleague Mei Sing Ong, PhD, a leading machine learning researcher in clinical informatics, in a PCORI-fundedi methodoogy development projec,t Dr. Natter has been developing and validating the usage of large language models (LLMs) in new approaches to extract clinical variables relevant to JIA research from multi-source data, leveraging the combined utility of EHR and registry data.

An additional focus for Dr. Natter is the exploration of the role of the exposome in the development and progression of pediatric rheumatic and other autoimmune diseases. As PI of an NIH EXACT-PLAN (EXposome in Autoimmune Disease Collaborating Teams PLANning) grant, he has been leading efforts to incorporate exposome data into biomedical data repositories for pediatric rheumatic diseases investigators, including within CARRA and the Genomic Information Common network.

Research Background

Dr. Natter is fellowship trained clinical informaticist and a board-certified, practicing pediatric rheumatologist, whose research is focused at the intersection of chronic pediatric rheumatic and other autoimmune diseases and informatics tools development, application, and analysis. He has served as Director of Informatics for the Clinical Immunology Society (CIS) and the Childhood Arthritis and Rheumatology Research Alliance (CARRA), as well as in an advisory role to other efforts focused on improvidng the care of individuals with chronic pediatric-onset diseases.

Publications

  1. Baseline Clinical Features and Biomarker Profiles of the Childhood Arthritis and Rheumatology Research Alliance Systemic Juvenile Idiopathic Arthritis-Associated Lung Disease Cohort. Arthritis Care Res (Hoboken). 2026 Aug; 78(8):1036-1048. View Abstract
  2. Three-Year Outcomes and Latent Class Trajectory Analysis of the Childhood Arthritis and Rheumatology Research Alliance Polyarticular JIA Consensus Treatment Plans Study. Arthritis Rheumatol. 2025 Oct; 77(10):1433-1441. View Abstract
  3. Case 17-2022: A 17-Year-Old Boy with Chest Pain. Reply. N Engl J Med. 2022 09 15; 387(11):1051-1052. View Abstract
  4. Case 17-2022: A 17-Year-Old Boy with Chest Pain. N Engl J Med. 2022 06 09; 386(23):2222-2231. View Abstract
  5. New-onset hypogammaglobulinaemia and infectious complications associated with rituximab use in childhood-onset rheumatic diseases. Rheumatology (Oxford). 2022 04 11; 61(4):1610-1620. View Abstract
  6. The importance of rigorous methods in observational comparative effectiveness studies of rare diseases: comment on the article by Ruperto et al. Arthritis Rheumatol. 2022 05; 74(5):912-913. View Abstract
  7. Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2022 07; 81(7):998-1005. View Abstract
  8. Feasibility and Efficacy of Online Strategies to Recruit Parents of Children With Rheumatic Diseases for Research. ACR Open Rheumatol. 2022 May; 4(5):410-416. View Abstract
  9. Using the Electronic Health Record to Enhance Care in Pediatric Rheumatology. Rheum Dis Clin North Am. 2022 02; 48(1):245-258. View Abstract
  10. Characterisation of paediatric pulmonary hypertensive vascular disease from the PPHNet Registry. Eur Respir J. 2022 01; 59(1). View Abstract
  11. Optimizing the Start Time of Biologics in Polyarticular Juvenile Idiopathic Arthritis: A Comparative Effectiveness Study of Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans. Arthritis Rheumatol. 2021 10; 73(10):1898-1909. View Abstract
  12. Improved Disease Course Associated With Early Initiation of Biologics in Polyarticular Juvenile Idiopathic Arthritis: Trajectory Analysis of a Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans Study. Arthritis Rheumatol. 2021 10; 73(10):1910-1920. View Abstract
  13. Claims-Based Algorithms for Identifying Patients With Pulmonary Hypertension: A Comparison of Decision Rules and Machine-Learning Approaches. J Am Heart Assoc. 2020 10 20; 9(19):e016648. View Abstract
  14. Validation of an Electronic Health Record-Based Suicide Risk Prediction Modeling Approach Across Multiple Health Care Systems. JAMA Netw Open. 2020 03 02; 3(3):e201262. View Abstract
  15. A federated EHR network data completeness tracking system. J Am Med Inform Assoc. 2019 07 01; 26(7):637-645. View Abstract
  16. Racial and Ethnic Differences in Pediatric Pulmonary Hypertension: An Analysis of the Pediatric Pulmonary Hypertension Network Registry. J Pediatr. 2019 08; 211:63-71.e6. View Abstract
  17. The Association of Black Cardiologists (ABC) Cardiovascular Implementation Study (CVIS): A Research Registry Integrating Social Determinants to Support Care for Underserved Patients. Int J Environ Res Public Health. 2019 05 10; 16(9). View Abstract
  18. The Ad-Hoc Uncertainty Principle of Patient Privacy. AMIA Jt Summits Transl Sci Proc. 2018; 2017:132-138. View Abstract
  19. Adding patient-reported outcomes to a multisite registry to quantify quality of life and experiences of disease and treatment for youth with juvenile idiopathic arthritis. J Patient Rep Outcomes. 2018; 2. View Abstract
  20. A Computable Phenotype Improves Cohort Ascertainment in a Pediatric Pulmonary Hypertension Registry. J Pediatr. 2017 09; 188:224-231.e5. View Abstract
  21. Learning a Comorbidity-Driven Taxonomy of Pediatric Pulmonary Hypertension. Circ Res. 2017 Aug 04; 121(4):341-353. View Abstract
  22. The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months. Pediatr Rheumatol Online J. 2017 Apr 17; 15(1):30. View Abstract
  23. C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR. PLoS One. 2016; 11(3):e0152722. View Abstract
  24. Supporting Multi-sourced Medication Information in i2b2. AMIA Annu Symp Proc. 2015; 2015:747-55. View Abstract
  25. Scalable Collaborative Infrastructure for a Learning Healthcare System (SCILHS): architecture. J Am Med Inform Assoc. 2014 Jul-Aug; 21(4):615-20. View Abstract
  26. A167: variations in patterns of care across pediatric rheumatic diseases in the childhood arthritis & rheumatology alliance network registry. Arthritis Rheumatol. 2014 Mar; 66 Suppl 11:S215-6. View Abstract
  27. Using registries to identify adverse events in rheumatic diseases. Pediatrics. 2013 Nov; 132(5):e1384-94. View Abstract
  28. Next-generation registries: fusion of data for care, and research. AMIA Jt Summits Transl Sci Proc. 2013; 2013:164-7. View Abstract
  29. An i2b2-based, generalizable, open source, self-scaling chronic disease registry. J Am Med Inform Assoc. 2013 Jan 01; 20(1):172-9. View Abstract
  30. Association between pediatric psoriasis and the metabolic syndrome. J Am Acad Dermatol. 2012 Jun; 66(6):1012-3. View Abstract
  31. Somatic KRAS mutations associated with a human nonmalignant syndrome of autoimmunity and abnormal leukocyte homeostasis. Blood. 2011 Mar 10; 117(10):2883-6. View Abstract

Contact Marc Natter

Phone: 857-218-3531
Email:
Print Profile