ACGT: advancing clinico-genomic trials on cancer - four years of experience

The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obtained.

Putting biomedical ontologies to work

OBJECTIVES

Biomedical ontologies exist to serve integration of clinical and experimental data, and it is critical to their success that they be put to widespread use in the annotation of data. How, then, can ontologies achieve the sort of user-friendliness, reliability, cost-effectiveness, and breadth of coverage that is necessary to ensure extensive usage?

METHODS

Our focus here is on two different sets of answers to these questions that have been proposed, on the one hand in medicine, by the SNOMED CT community, and on the other hand in biology, by the OBO Foundry. We address more specifically the issue as to how adherence to certain development principles can advance the usability and effectiveness of an ontology or terminology resource, for example by allowing more accurate maintenance, more reliable application, and more efficient interoperation with other ontologies and information resources.

RESULTS

SNOMED CT and the OBO Foundry differ considerably in their general approach. Nevertheless, a general trend towards more formal rigor and cross-domain interoperability can be seen in both and we argue that this trend should be accepted by all similar initiatives in the future.

CONCLUSIONS

Future efforts in ontology development have to address the need for harmonization and integration of ontologies across disciplinary borders, and for this, coherent formalization of ontologies is a pre-requisite.

The ObTiMA system - ontology-based managing of clinical trials

Clinical Trial Management Systems promise to help researchers in managing the large amounts of data occurring in clinical trials. In such systems Case Report Forms for capturing all patient data can usually be defined freely for a given trial. But if database definitions are automatically derived from such trial-specific definitions then the collected data cannot be easily compared to or integrated into other trials. We address this interoperability issue with an approach based on ontology and semantic data mediation. This resulted in the development of the ObTiMA system which is composed of a component for setting-up clinical trials and another for handling patient data during trials. Both components offer data reusability by relying on shared concepts defined in an ontology covering the whole cancer care and research spectrum.

User-specific perspectives on ontologies

Ontologies are more and more used in clinical informatics in different settings and supporting different functionalities. Most experts see the role of ontologies as operating in a black box and being invisible for the end-user. With respect to some of the systems that have recently been developed this is only partly possible. Therefore, we provide a methodology to create an end-user perspective on a clinical ontology. This will foster participation of the clinical expert in both ontology exploitation and ontology maintenance. This methodology does not only provide the basis for a better integration of the experts into the ontology-based system, but it can be used to support patient empowerment by helping the patient to understand the content that is stored and partake in its management.

Ontology based data management systems for post-genomic clinical trials within a European Grid Infrastructure for Cancer Research

Data management in post-genomic clinical trials is the process of collecting and validating clinical and genomic data with the goal to answer research questions and to preserve it for future scientific investigation. Comprehensive metadata describing the semantics of the data are needed to leverage it for further research like cross-trial analysis. Current clinical trial management systems mostly lack sufficient metadata and are not semantically interoperable. This paper outlines our approach to develop an application that allows trial chairmen to design their trial and especially the required data management system with comprehensive metadata according to their needs, integrating a clinical trial ontology into the design process. To demonstrate the built-in interoperability of data management systems developed in this way, we integrate these applications into a European biomedical Grid for cancer research in a way that the research data collected in the data management systems can be seamlessly analyzed and mined by researchers.

A semantic grid infrastructure enabling integrated access and analysis of multilevel biomedical data in support of postgenomic clinical trials on cancer

This paper reports on original results of the Advancing Clinico-Genomic Trials on Cancer integrated project focusing on the design and development of a European biomedical grid infrastructure in support of multicentric, postgenomic clinical trials (CTs) on cancer. Postgenomic CTs use multilevel clinical and genomic data and advanced computational analysis and visualization tools to test hypothesis in trying to identify the molecular reasons for a disease and the stratification of patients in terms of treatment. This paper provides a presentation of the needs of users involved in postgenomic CTs, and presents such needs in the form of scenarios, which drive the requirements engineering phase of the project. Subsequently, the initial architecture specified by the project is presented, and its services are classified and discussed. A key set of such services are those used for wrapping heterogeneous clinical trial management systems and other public biological databases. Also, the main technological challenge, i.e. the design and development of semantically rich grid services is discussed. In achieving such an objective, extensive use of ontologies and metadata are required. The Master Ontology on Cancer, developed by the project, is presented, and our approach to develop the required metadata registries, which provide semantically rich information about available data and computational services, is provided. Finally, a short discussion of the work lying ahead is included.

Establishing and harmonizing ontologies in an interdisciplinary health care clinical research environment

Ontologies are being ever more commonly used in biomedical informatics. The paper provides a survey of some of these uses, and of the relations between ontologies and other terminology resources. In order for ontologies to become truly useful, two objectives must be met. First, ways must be found for the transparent evaluation of ontologies. Second, existing ontologies need to be harmonized. The authors argue that one key foundation for both ontology evaluation and harmonization is the adoption of a realist paradigm in ontology development. For science-based ontologies of the sort which concern us in the eHealth arena, it is reality that provides the common benchmark against which ontologies can be evaluated and aligned within larger frameworks. Given the current multitude of ontologies in the biomedical domain the need for harmonization is becoming ever more urgent. An example of such harmonization within the ACGT project is described, which draws on ontology-based computing as a basis for sharing clinical and laboratory data on cancer research.

Developing a European grid infrastructure for cancer research: vision, architecture and services

Life sciences are currently at the centre of an information revolution. The nature and amount of information now available opens up areas of research that were once in the realm of science fiction. During this information revolution, the data-gathering capabilities have greatly surpassed the data-analysis techniques. Data integration across heterogeneous data sources and data aggregation across different aspects of the biomedical spectrum, therefore, is at the centre of current biomedical and pharmaceutical R&D.This paper reports on original results from the ACGT integrated project, focusing on the design and development of a European Biomedical Grid infrastructure in support of multi-centric, post-genomic clinical trials (CTs) on cancer. Post-genomic CTs use multi-level clinical and genomic data and advanced computational analysis and visualization tools to test hypotheses in trying to identify the molecular reasons for a disease and the stratification of patients in terms of treatment.The paper provides a presentation of the needs of users involved in post-genomic CTs and presents indicative scenarios, which drive the requirements of the engineering phase of the project. Subsequently, the initial architecture specified by the project is presented, and its services are classified and discussed. A range of such key services, including the Master Ontology on sCancer, which lie at the heart of the integration architecture of the project, is presented. Special efforts have been taken to describe the methodological and technological framework of the project, enabling the creation of a legally compliant and trustworthy infrastructure. Finally, a short discussion of the forthcoming work is included, and the potential involvement of the cancer research community in further development or utilization of the infrastructure is described.

The derives_from relation in biomedical ontologies

This paper is part of the ongoing efforts within the framework of the Open Biomedical Ontologies (OBO) ontology library to optimize the treatment of relations in biomedical informatics. When ovum and sperm fuse to form a zygote, then the latter is derived from the former. This derives_from relation is of huge importance not only in embryology but also in every other science dealing with ontogenetic processes. This study examines critically the treatment of derives_from in the OBO Relation Ontology in light of its conformity to the underlying processes of development and transformation in biological and medical reality.