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Foran DJ, Chen W, Kurc T, Gupta R, Kaczmarzyk JR, Torre-Healy LA, Bremer E, Ajjarapu S, Do N, Harris G, Stroup A, Durbin E, Saltz JH. An Intelligent Search & Retrieval System (IRIS) and Clinical and Research Repository for Decision Support Based on Machine Learning and Joint Kernel-based Supervised Hashing. Cancer Inform 2024; 23:11769351231223806. [PMID: 38322427 PMCID: PMC10840403 DOI: 10.1177/11769351231223806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024] Open
Abstract
Large-scale, multi-site collaboration is becoming indispensable for a wide range of research and clinical activities in oncology. To facilitate the next generation of advances in cancer biology, precision oncology and the population sciences it will be necessary to develop and implement data management and analytic tools that empower investigators to reliably and objectively detect, characterize and chronicle the phenotypic and genomic changes that occur during the transformation from the benign to cancerous state and throughout the course of disease progression. To facilitate these efforts it is incumbent upon the informatics community to establish the workflows and architectures that automate the aggregation and organization of a growing range and number of clinical data types and modalities ranging from new molecular and laboratory tests to sophisticated diagnostic imaging studies. In an attempt to meet those challenges, leading health care centers across the country are making steep investments to establish enterprise-wide, data warehouses. A significant limitation of many data warehouses, however, is that they are designed to support only alphanumeric information. In contrast to those traditional designs, the system that we have developed supports automated collection and mining of multimodal data including genomics, digital pathology and radiology images. In this paper, our team describes the design, development and implementation of a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide actionable insight into the underlying characteristics of the tumor environment that would not be revealed using standard methods and tools. The System features a flexible Extract, Transform and Load (ETL) interface that enables it to adapt to aggregate data originating from different clinical and research sources depending on the specific EHR and other data sources utilized at a given deployment site.
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Affiliation(s)
- David J Foran
- Center for Biomedical Informatics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Wenjin Chen
- Center for Biomedical Informatics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, The State University of New York, Stony Brook, NY, USA
| | - Rajarshi Gupta
- Department of Biomedical Informatics, Stony Brook University, The State University of New York, Stony Brook, NY, USA
| | | | | | - Erich Bremer
- Department of Biomedical Informatics, Stony Brook University, The State University of New York, Stony Brook, NY, USA
| | | | - Nhan Do
- VA Healthcare System Jamaica Plain Campus, Boston, MA, USA
| | - Gerald Harris
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Antoinette Stroup
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Eric Durbin
- Kentucky Cancer Registry, Markey Cancer Center, Lexington, KY, USA
| | - Joel H Saltz
- Department of Biomedical Informatics, Stony Brook University, The State University of New York, Stony Brook, NY, USA
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Kiessling F, Schulz V. Perspectives of Evidence-Based Therapy Management. Nuklearmedizin 2023; 62:314-322. [PMID: 37802059 DOI: 10.1055/a-2159-6949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
BACKGROUND Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic procedures must describe the diseases in sufficient detail to allow selection of appropriate therapy and to sensitively track therapy response. Anatomical features are often not sufficient for this purpose and there is a need to image molecular and pathophysiological processes. METHOD Two imaging strategies can be pursued: molecular imaging attempts to image a few biomarkers that play key roles in pathological processes. Alternatively, patterns describing a biological process can be identified from the synopsis of multiple (non-specific) imaging markers, possibly in combination with omics and other clinical findings. Here, AI-based methods are increasingly being used. RESULTS Both strategies of evidence-based therapy management are explained in this review article and examples and clinical successes are presented. In this context, reviews of clinically approved molecular diagnostics and decision support systems are listed. Furthermore, since reliable, representative, and sufficiently large datasets are further important prerequisites for AI-assisted multiparametric analyses, concepts are presented to make data available in a structured way, e. g., using Generative Adversarial Networks to complement databases with virtual cases and to build completely anonymous reference databases. CONCLUSION Molecular imaging and computer-assisted cluster analysis of diagnostic data are complementary methods to describe pathophysiological processes. Both methods have the potential to improve (evidence-based) the future management of therapies, partly on their own but also in combined approaches. KEY POINTS · Molecular imaging and radiomics provide valuable complementary disease biomarkers.. · Data-driven, model-based, and hybrid model-based integrated diagnostics advance precision medicine.. · Synthetic data generation may become essential in the development process of future AI methods..
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Affiliation(s)
- Fabian Kiessling
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany
- Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
| | - Volkmar Schulz
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany
- Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
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Pallier K, Prot O, Naldi S, Silva F, Denis T, Giry O, Leobon S, Deluche E, Tubiana-Mathieu N. Patient Identification and Tumor Identification Management: Quality Program in a Cancer Multicentric Clinical Data Warehouse. Cancer Inform 2023; 22:11769351231172609. [PMID: 37223319 PMCID: PMC10201142 DOI: 10.1177/11769351231172609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/12/2023] [Indexed: 05/25/2023] Open
Abstract
Background The Regional Basis of Solid Tumor (RBST), a clinical data warehouse, centralizes information related to cancer patient care in 5 health establishments in 2 French departments. Purpose To develop algorithms matching heterogeneous data to "real" patients and "real" tumors with respect to patient identification (PI) and tumor identification (TI). Methods A graph database programed in java Neo4j was used to build the RBST with data from ~20 000 patients. The PI algorithm using the Levenshtein distance was based on the regulatory criteria identifying a patient. A TI algorithm was built on 6 characteristics: tumor location and laterality, date of diagnosis, histology, primary and metastatic status. Given the heterogeneous nature and semantics of the collected data, the creation of repositories (organ, synonym, and histology repositories) was required. The TI algorithm used the Dice coefficient to match tumors. Results Patients matched if there was complete agreement of the given name, surname, sex, and date/month/year of birth. These parameters were assigned weights of 28%, 28%, 21%, and 23% (with 18% for year, 2.5% for month, and 2.5% for day), respectively. The algorithm had a sensitivity of 99.69% (95% confidence interval [CI] [98.89%, 99.96%]) and a specificity of 100% (95% CI [99.72%, 100%]). The TI algorithm used repositories, weights were assigned to the diagnosis date and associated organ (37.5% and 37.5%, respectively), laterality (16%) histology (5%), and metastatic status (4%). This algorithm had a sensitivity of 71% (95% CI [62.68%, 78.25%]) and a specificity of 100% (95% CI [94.31%, 100%]). Conclusion The RBST encompasses 2 quality controls: PI and TI. It facilitates the implementation of transversal structuring and assessments of the performance of the provided care.
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Affiliation(s)
- Karine Pallier
- Centre de Coordination en Cancérologie
de la Haute-Vienne - 3C87, CHU de Limoges, Limoges, France
| | - Olivier Prot
- Univ. Limoges, CNRS, XLIM, UMR 7252,
Limoges, France
| | - Simone Naldi
- Univ. Limoges, CNRS, XLIM, UMR 7252,
Limoges, France
| | | | - Thierry Denis
- Département Exploitation Réseaux et
Infrastructures - DSI, CHU Limoges, Limoges, France
| | - Olivier Giry
- Département Exploitation Réseaux et
Infrastructures - DSI, CHU Limoges, Limoges, France
| | - Sophie Leobon
- Department of oncology, CHU de Limoges,
Limoges, France
| | - Elise Deluche
- Department of oncology, CHU de Limoges,
Limoges, France
| | - Nicole Tubiana-Mathieu
- Centre de Coordination en Cancérologie
de la Haute-Vienne - 3C87, CHU de Limoges, Limoges, France
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Kaspar M, Liman L, Morbach C, Dietrich G, Seidlmayer LK, Puppe F, Störk S. Querying a Clinical Data Warehouse for Combinations of Clinical and Imaging Data. J Digit Imaging 2023; 36:715-724. [PMID: 36417023 PMCID: PMC10039164 DOI: 10.1007/s10278-022-00727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
This study aims to show the feasibility and benefit of single queries in a research data warehouse combining data from a hospital's clinical and imaging systems. We used a comprehensive integration of a production picture archiving and communication system (PACS) with a clinical data warehouse (CDW) for research to create a system that allows data from both domains to be queried jointly with a single query. To achieve this, we mapped the DICOM information model to the extended entity-attribute-value (EAV) data model of a CDW, which allows data linkage and query constraints on multiple levels: the patient, the encounter, a document, and a group level. Accordingly, we have integrated DICOM metadata directly into CDW and linked it to existing clinical data. We included data collected in 2016 and 2017 from the Department of Internal Medicine in this analysis for two query inquiries from researchers targeting research about a disease and in radiology. We obtained quantitative information about the current availability of combinations of clinical and imaging data using a single multilevel query compiled for each query inquiry. We compared these multilevel query results to results that linked data at a single level, resulting in a quantitative representation of results that was up to 112% and 573% higher. An EAV data model can be extended to store data from clinical systems and PACS on multiple levels to enable combined querying with a single query to quickly display actual frequency data.
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Affiliation(s)
- Mathias Kaspar
- Department of Health Services Research, Carl Von Ossietzky University of Oldenburg, Campus Haarentor, V4/1/129, Ammerländer Heerstraße 140, 26129, Oldenburg, Germany.
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany.
| | - Leon Liman
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany
| | - Georg Dietrich
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | | | - Frank Puppe
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany
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Bocquet F, Raimbourg J, Bigot F, Simmet V, Campone M, Frenel JS. Opportunities and Obstacles to the Development of Health Data Warehouses in Hospitals in France: The Recent Experience of Comprehensive Cancer Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1645. [PMID: 36674399 PMCID: PMC9861145 DOI: 10.3390/ijerph20021645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Big Data and Artificial Intelligence can profoundly transform medical practices, particularly in oncology. Comprehensive Cancer Centers have a major role to play in this revolution. With the purpose of advancing our knowledge and accelerating cancer research, it is urgent to make this pool of data usable through the development of robust and effective data warehouses. Through the recent experience of Comprehensive Cancer Centers in France, this article shows that, while the use of hospital data warehouses can be a source of progress by taking into account multisource, multidomain and multiscale data for the benefit of knowledge and patients, it nevertheless raises technical, organizational and legal issues that still need to be addressed. The objectives of this article are threefold: 1. to provide insight on public health stakes of development in Comprehensive Cancer Centers to manage cancer patients comprehensively; 2. to set out a challenge of structuring the data from within them; 3. to outline the legal issues of implementation to carry out real-world evidence studies. To meet objective 1, this article firstly proposed a discussion on the relevance of an integrated approach to manage cancer and the formidable tool that data warehouses represent to achieve this. To address objective 2, we carried out a literature review to screen the articles published in PubMed and Google Scholar through the end of 2022 on the use of data warehouses in French Comprehensive Cancer Centers. Seven publications dealing specifically with the issue of data structuring were selected. To achieve objective 3, we presented and commented on the main aspects of French and European legislation and regulations in the field of health data, hospital data warehouses and real-world evidence.
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Affiliation(s)
- François Bocquet
- Data Factory & Analytics Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Law and Social Change Laboratory, Faculty of Law and Political Sciences, CNRS UMR 6297, Nantes University, 44313 Nantes, France
| | - Judith Raimbourg
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
| | - Frédéric Bigot
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
| | - Victor Simmet
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
| | - Mario Campone
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
| | - Jean-Sébastien Frenel
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
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The Challenges of Implementing Comprehensive Clinical Data Warehouses in Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127379. [PMID: 35742627 PMCID: PMC9223495 DOI: 10.3390/ijerph19127379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 02/06/2023]
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7
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Kiessling F, Schulz V. Perspectives of Evidence-Based Therapy Management. ROFO-FORTSCHR RONTG 2022; 194:728-736. [PMID: 35545101 DOI: 10.1055/a-1752-0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic procedures must describe the diseases in sufficient detail to allow selection of appropriate therapy and to sensitively track therapy response. Anatomical features are often not sufficient for this purpose and there is a need to image molecular and pathophysiological processes. METHOD Two imaging strategies can be pursued: molecular imaging attempts to image a few biomarkers that play key roles in pathological processes. Alternatively, patterns describing a biological process can be identified from the synopsis of multiple (non-specific) imaging markers, possibly in combination with omics and other clinical findings. Here, AI-based methods are increasingly being used. RESULTS Both strategies of evidence-based therapy management are explained in this review article and examples and clinical successes are presented. In this context, reviews of clinically approved molecular diagnostics and decision support systems are listed. Furthermore, since reliable, representative, and sufficiently large datasets are further important prerequisites for AI-assisted multiparametric analyses, concepts are presented to make data available in a structured way, e. g., using Generative Adversarial Networks to complement databases with virtual cases and to build completely anonymous reference databases. CONCLUSION Molecular imaging and computer-assisted cluster analysis of diagnostic data are complementary methods to describe pathophysiological processes. Both methods have the potential to improve (evidence-based) the future management of therapies, partly on their own but also in combined approaches. KEY POINTS · Molecular imaging and radiomics provide valuable complementary disease biomarkers.. · Data-driven, model-based, and hybrid model-based integrated diagnostics advance precision medicine.. · Synthetic data generation may become essential in the development process of future AI methods.. CITATION FORMAT · Kiessling F, Schulz V, . Perspectives of Evidence-Based Therapy Management. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1752-0839.
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Affiliation(s)
- Fabian Kiessling
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany.,Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
| | - Volkmar Schulz
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany.,Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
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8
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Optimizing the Retrieval of the Vital Status of Cancer Patients for Health Data Warehouses by Using Open Government Data in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074272. [PMID: 35409956 PMCID: PMC8998644 DOI: 10.3390/ijerph19074272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023]
Abstract
Electronic Medical Records (EMR) and Electronic Health Records (EHR) are often missing critical information about the death of a patient, although it is an essential metric for medical research in oncology to assess survival outcomes, particularly for evaluating the efficacy of new therapeutic approaches. We used open government data in France from 1970 to September 2021 to identify deceased patients and match them with patient data collected from the Institut de Cancérologie de l’Ouest (ICO) data warehouse (Integrated Center of Oncology—the third largest cancer center in France) between January 2015 and November 2021. To meet our objective, we evaluated algorithms to perform a deterministic record linkage: an exact matching algorithm and a fuzzy matching algorithm. Because we lacked reference data, we needed to assess the algorithms by estimating the number of homonyms that could lead to false links, using the same open dataset of deceased persons in France. The exact matching algorithm allowed us to double the number of dates of death in the ICO data warehouse, and the fuzzy matching algorithm tripled it. Studying homonyms assured us that there was a low risk of misidentification, with precision values of 99.96% for the exact matching and 99.68% for the fuzzy matching. However, estimating the number of false negatives proved more difficult than anticipated. Nevertheless, using open government data can be a highly interesting way to improve the completeness of the date of death variable for oncology patients in data warehouses
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Yi T, Pan I, Collins S, Chen F, Cueto R, Hsieh B, Hsieh C, Smith JL, Yang L, Liao WH, Merck LH, Bai H, Merck D. DICOM Image ANalysis and Archive (DIANA): an Open-Source System for Clinical AI Applications. J Digit Imaging 2021; 34:1405-1413. [PMID: 34727303 PMCID: PMC8669082 DOI: 10.1007/s10278-021-00488-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 12/26/2022] Open
Abstract
In the era of data-driven medicine, rapid access and accurate interpretation of medical images are becoming increasingly important. The DICOM Image ANalysis and Archive (DIANA) system is an open-source, lightweight, and scalable Python interface that enables users to interact with hospital Picture Archiving and Communications Systems (PACS) to access such data. In this work, DIANA functionality was detailed and evaluated in the context of retrospective PACS data retrieval and two prospective clinical artificial intelligence (AI) pipelines: bone age (BA) estimation and intra-cranial hemorrhage (ICH) detection. DIANA orchestrates activity beginning with post-acquisition study discovery and ending with online notifications of findings. For AI applications, system latency (exam completion to system report time) was quantified and compared to that of clinicians (exam completion to initial report creation time). Mean DIANA latency was 9.04 ± 3.83 and 20.17 ± 10.16 min compared to clinician latency of 51.52 ± 58.9 and 65.62 ± 110.39 min for BA and ICH, respectively, with DIANA latencies being significantly lower (p < 0.001). DIANA's capabilities were also explored and found effective in retrieving and anonymizing protected health information for "big-data" medical imaging research and analysis. Mean per-image retrieval times were 1.12 ± 0.50 and 0.08 ± 0.01 s across x-ray and computed tomography studies, respectively. The data herein demonstrate that DIANA can flexibly integrate into existing hospital infrastructure and improve the process by which researchers/clinicians access imaging repository data. This results in a simplified workflow for large data retrieval and clinical integration of AI models.
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Affiliation(s)
- Thomas Yi
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ian Pan
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Scott Collins
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
| | - Fiona Chen
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Ben Hsieh
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
| | - Celina Hsieh
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jessica L Smith
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Li Yang
- Department of Neurology, Second Xiangya Hospital, Changsha, China
| | - Wei-Hua Liao
- Department of Radiology, Xiangya Hospital, Changsha, China
| | - Lisa H Merck
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA
- University of Florida, Gainesville, FL, USA
| | - Harrison Bai
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
- Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Derek Merck
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
- University of Florida, Gainesville, FL, USA
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Eschrich SA, Teer JK, Reisman P, Siegel E, Challa C, Lewis P, Fellows K, Malpica E, Carvajal R, Gonzalez G, Cukras S, Betin-Montes M, Aden-Buie G, Avedon M, Manning D, Tan AC, Fridley BL, Gerke T, Van Looveren M, Blake A, Greenman J, Rollison D. Enabling Precision Medicine in Cancer Care Through a Molecular Data Warehouse: The Moffitt Experience. JCO Clin Cancer Inform 2021; 5:561-569. [PMID: 33989014 DOI: 10.1200/cci.20.00175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The use of genomics within cancer research and clinical oncology practice has become commonplace. Efforts such as The Cancer Genome Atlas have characterized the cancer genome and suggested a wealth of targets for implementing precision medicine strategies for patients with cancer. The data produced from research studies and clinical care have many potential secondary uses beyond their originally intended purpose. Effective storage, query, retrieval, and visualization of these data are essential to create an infrastructure to enable new discoveries in cancer research. METHODS Moffitt Cancer Center implemented a molecular data warehouse to complement the extensive enterprise clinical data warehouse (Health and Research Informatics). Seven different sequencing experiment types were included in the warehouse, with data from institutional research studies and clinical sequencing. RESULTS The implementation of the molecular warehouse involved the close collaboration of many teams with different expertise and a use case-focused approach. Cornerstones of project success included project planning, open communication, institutional buy-in, piloting the implementation, implementing custom solutions to address specific problems, data quality improvement, and data governance, unique aspects of which are featured here. We describe our experience in selecting, configuring, and loading molecular data into the molecular data warehouse. Specifically, we developed solutions for heterogeneous genomic sequencing cohorts (many different platforms) and integration with our existing clinical data warehouse. CONCLUSION The implementation was ultimately successful despite challenges encountered, many of which can be generalized to other research cancer centers.
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Affiliation(s)
- Steven A Eschrich
- Department of Biostatistics & Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - Jamie K Teer
- Department of Biostatistics & Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | | | - Erin Siegel
- Total Cancer Care, Moffitt Cancer Center, Tampa, FL
| | | | - Patricia Lewis
- Data Quality and Business Intelligence, Moffitt Cancer Center, Tampa, FL
| | - Katherine Fellows
- Data Quality and Business Intelligence, Moffitt Cancer Center, Tampa, FL
| | | | - Rodrigo Carvajal
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL
| | - Guillermo Gonzalez
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL
| | - Scott Cukras
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL
| | - Miguel Betin-Montes
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, FL
| | | | - Melissa Avedon
- Basic, Population, and Quantitative Science Shared Resource Administration, Moffitt Cancer Center, Tampa, FL
| | - Daniel Manning
- Information Technology, Moffitt Cancer Center, Tampa, FL
| | - Aik Choon Tan
- Department of Biostatistics & Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - Brooke L Fridley
- Department of Biostatistics & Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - Travis Gerke
- Health Informatics, Moffitt Cancer Center, Tampa, FL
| | | | | | | | - Dana Rollison
- Department of Epidemiology, Moffitt Cancer Center, Tampa, FL
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11
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Zhang PF, Zheng XH, Li XZ, Sun L, Jia WH. Informatics Management of Tumor Specimens in the Era of Big Data: Challenges and Solutions. Biopreserv Biobank 2021; 19:531-542. [PMID: 34030478 DOI: 10.1089/bio.2020.0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Biomedical data bear the potential to facilitate personalized diagnosis and precision treatment. In the era of Big Data, high-quality annotation of human specimens has become the primary mission of biobankers, especially for tumor biobanks with large amounts of "omics" and clinical data. However, the lack of agreed-upon standardization and the gap among heterogeneous databases make information application and communication a major challenge. International efforts are underway to develop national projects on informatics management. The aim of this review is to provide references in specimen annotation to regulate and take full advantage of biological and biomedical information. First, critical data categories that are vital for specimen applications, including sample attributes, clinical data, preanalytical variations, and analytical records, are systematically listed for subsequent data mining. Second, current standards and guidelines related to biospecimen information are reviewed, and proper standards for tumor biobanks are recommended. In particular, commonly-used approaches and functionalities of data management are summarized and discussed. This review highlights the importance of informatics management of tumor specimens, defines critical data types, recommends data standards, and presents the methodologies of data harmonization for biobankers to reach high quality annotation of biospecimens.
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Affiliation(s)
- Pei-Fen Zhang
- State Key Laboratory of Oncology in South China, Tumor Biobank, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Xiao-Hui Zheng
- State Key Laboratory of Oncology in South China, Tumor Biobank, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Xi-Zhao Li
- State Key Laboratory of Oncology in South China, Tumor Biobank, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
| | - Lin Sun
- Department of Information, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, P. R. China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Tumor Biobank, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
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12
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Syed S, Syed M, Syeda HB, Garza M, Bennett W, Bona J, Begum S, Baghal A, Zozus M, Prior F. API Driven On-Demand Participant ID Pseudonymization in Heterogeneous Multi-Study Research. Healthc Inform Res 2021; 27:39-47. [PMID: 33611875 PMCID: PMC7921568 DOI: 10.4258/hir.2021.27.1.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/23/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To facilitate clinical and translational research, imaging and non-imaging clinical data from multiple disparate systems must be aggregated for analysis. Study participant records from various sources are linked together and to patient records when possible to address research questions while ensuring patient privacy. This paper presents a novel tool that pseudonymizes participant identifiers (PIDs) using a researcher-driven automated process that takes advantage of application-programming interface (API) and the Perl Open-Source Digital Imaging and Communications in Medicine Archive (POSDA) to further de-identify PIDs. The tool, on-demand cohort and API participant identifier pseudonymization (O-CAPP), employs a pseudonymization method based on the type of incoming research data. METHODS For images, pseudonymization of PIDs is done using API calls that receive PIDs present in Digital Imaging and Communications in Medicine (DICOM) headers and returns the pseudonymized identifiers. For non-imaging clinical research data, PIDs provided by study principal investigators (PIs) are pseudonymized using a nightly automated process. The pseudonymized PIDs (P-PIDs) along with other protected health information is further de-identified using POSDA. RESULTS A sample of 250 PIDs pseudonymized by O-CAPP were selected and successfully validated. Of those, 125 PIDs that were pseudonymized by the nightly automated process were validated by multiple clinical trial investigators (CTIs). For the other 125, CTIs validated radiologic image pseudonymization by API request based on the provided PID and P-PID mappings. CONCLUSIONS We developed a novel approach of an ondemand pseudonymization process that will aide researchers in obtaining a comprehensive and holistic view of study participant data without compromising patient privacy.
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Affiliation(s)
- Shorabuddin Syed
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Mahanazuddin Syed
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Hafsa Bareen Syeda
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Maryam Garza
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - William Bennett
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Jonathan Bona
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Salma Begum
- Department of Information Technology, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Ahmad Baghal
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
| | - Meredith Zozus
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX,
USA
| | - Fred Prior
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR,
USA
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13
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Abstract
PURPOSE OF REVIEW Healthcare has already been impacted by the fourth industrial revolution exemplified by tip of spear technology, such as artificial intelligence and quantum computing. Yet, there is much to be accomplished as systems remain suboptimal, and full interoperability of digital records is not realized. Given the footprint of technology in healthcare, the field of clinical immunology will certainly see improvements related to these tools. RECENT FINDINGS Biomedical informatics spans the gamut of technology in biomedicine. Within this distinct field, advances are being made, which allow for engineering of systems to automate disease detection, create computable phenotypes and improve record portability. Within clinical immunology, technologies are emerging along these lines and are expected to continue. SUMMARY This review highlights advancements in digital health including learning health systems, electronic phenotyping, artificial intelligence and use of registries. Technological advancements for improving diagnosis and care of patients with primary immunodeficiency diseases is also highlighted.
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14
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Cecchetti AA, Bhardwaj N, Murughiyan U, Kothakapu G, Sundaram U. Fueling Clinical and Translational Research in Appalachia: Informatics Platform Approach. JMIR Med Inform 2020; 8:e17962. [PMID: 33052114 PMCID: PMC7593861 DOI: 10.2196/17962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Appalachian population is distinct, not just culturally and geographically but also in its health care needs, facing the most health care disparities in the United States. To meet these unique demands, Appalachian medical centers need an arsenal of analytics and data science tools with the foundation of a centralized data warehouse to transform health care data into actionable clinical interventions. However, this is an especially challenging task given the fragmented state of medical data within Appalachia and the need for integration of other types of data such as environmental, social, and economic with medical data. OBJECTIVE This paper aims to present the structure and process of the development of an integrated platform at a midlevel Appalachian academic medical center along with its initial uses. METHODS The Appalachian Informatics Platform was developed by the Appalachian Clinical and Translational Science Institute's Division of Clinical Informatics and consists of 4 major components: a centralized clinical data warehouse, modeling (statistical and machine learning), visualization, and model evaluation. Data from different clinical systems, billing systems, and state- or national-level data sets were integrated into a centralized data warehouse. The platform supports research efforts by enabling curation and analysis of data using the different components, as appropriate. RESULTS The Appalachian Informatics Platform is functional and has supported several research efforts since its implementation for a variety of purposes, such as increasing knowledge of the pathophysiology of diseases, risk identification, risk prediction, and health care resource utilization research and estimation of the economic impact of diseases. CONCLUSIONS The platform provides an inexpensive yet seamless way to translate clinical and translational research ideas into clinical applications for regions similar to Appalachia that have limited resources and a largely rural population.
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Affiliation(s)
- Alfred A Cecchetti
- Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Niharika Bhardwaj
- Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Usha Murughiyan
- Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Gouthami Kothakapu
- Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Uma Sundaram
- Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
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15
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Gagalova KK, Leon Elizalde MA, Portales-Casamar E, Görges M. What You Need to Know Before Implementing a Clinical Research Data Warehouse: Comparative Review of Integrated Data Repositories in Health Care Institutions. JMIR Form Res 2020; 4:e17687. [PMID: 32852280 PMCID: PMC7484778 DOI: 10.2196/17687] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/09/2020] [Accepted: 07/17/2020] [Indexed: 12/23/2022] Open
Abstract
Background Integrated data repositories (IDRs), also referred to as clinical data warehouses, are platforms used for the integration of several data sources through specialized analytical tools that facilitate data processing and analysis. IDRs offer several opportunities for clinical data reuse, and the number of institutions implementing an IDR has grown steadily in the past decade. Objective The architectural choices of major IDRs are highly diverse and determining their differences can be overwhelming. This review aims to explore the underlying models and common features of IDRs, provide a high-level overview for those entering the field, and propose a set of guiding principles for small- to medium-sized health institutions embarking on IDR implementation. Methods We reviewed manuscripts published in peer-reviewed scientific literature between 2008 and 2020, and selected those that specifically describe IDR architectures. Of 255 shortlisted articles, we found 34 articles describing 29 different architectures. The different IDRs were analyzed for common features and classified according to their data processing and integration solution choices. Results Despite common trends in the selection of standard terminologies and data models, the IDRs examined showed heterogeneity in the underlying architecture design. We identified 4 common architecture models that use different approaches for data processing and integration. These different approaches were driven by a variety of features such as data sources, whether the IDR was for a single institution or a collaborative project, the intended primary data user, and purpose (research-only or including clinical or operational decision making). Conclusions IDR implementations are diverse and complex undertakings, which benefit from being preceded by an evaluation of requirements and definition of scope in the early planning stage. Factors such as data source diversity and intended users of the IDR influence data flow and synchronization, both of which are crucial factors in IDR architecture planning.
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Affiliation(s)
- Kristina K Gagalova
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada.,Bioinformatics Graduate Program, University of British Columbia, Vancouver, BC, Canada.,Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - M Angelica Leon Elizalde
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Elodie Portales-Casamar
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Matthias Görges
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
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16
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Pavlenko E, Strech D, Langhof H. Implementation of data access and use procedures in clinical data warehouses. A systematic review of literature and publicly available policies. BMC Med Inform Decis Mak 2020; 20:157. [PMID: 32652989 PMCID: PMC7353743 DOI: 10.1186/s12911-020-01177-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/02/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The promises of improved health care and health research through data-intensive applications rely on a growing amount of health data. At the core of large-scale data integration efforts, clinical data warehouses (CDW) are also responsible for data governance, managing data access and (re)use. As the complexity of the data flow increases, greater transparency and standardization of criteria and procedures are required in order to maintain objective oversight and control. Therefore, the development of practice oriented and evidence-based policies is crucial. This study assessed the spectrum of data access and use criteria and procedures in clinical data warehouses governance internationally. METHODS We performed a systematic review of (a) the published scientific literature on CDW and (b) publicly available information on CDW data access, e.g., data access policies. A qualitative thematic analysis was applied to all included literature and policies. RESULTS Twenty-three scientific publications and one policy document were included in the final analysis. The qualitative analysis led to a final set of three main thematic categories: (1) requirements, including recipient requirements, reuse requirements, and formal requirements; (2) structures and processes, including review bodies and review values; and (3) access, including access limitations. CONCLUSIONS The description of data access and use governance in the scientific literature is characterized by a high level of heterogeneity and ambiguity. In practice, this might limit the effective data sharing needed to fulfil the high expectations of data-intensive approaches in medical research and health care. The lack of publicly available information on access policies conflicts with ethical requirements linked to principles of transparency and accountability. CDW should publicly disclose by whom and under which conditions data can be accessed, and provide designated governance structures and policies to increase transparency on data access. The results of this review may contribute to the development of practice-oriented minimal standards for the governance of data access, which could also result in a stronger harmonization, efficiency, and effectiveness of CDW.
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Affiliation(s)
- Elena Pavlenko
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- QUEST - Center for Transforming Biomedical Research, Charité - University Medicine, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Daniel Strech
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- QUEST - Center for Transforming Biomedical Research, Charité - University Medicine, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Holger Langhof
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
- QUEST - Center for Transforming Biomedical Research, Charité - University Medicine, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School (MHH), Hannover, Germany.
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17
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Jung HA, Sun JM, Lee SH, Ahn JS, Ahn MJ, Park K. Ten-year patient journey of stage III non-small cell lung cancer patients: A single-center, observational, retrospective study in Korea (Realtime autOmatically updated data warehOuse in healTh care; UNIVERSE-ROOT study). Lung Cancer 2020; 146:112-119. [PMID: 32526601 DOI: 10.1016/j.lungcan.2020.05.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Until the recent approval of immunotherapy after completing concurrent chemoradiotherapy (CCRT), there has been little progress in treating unresectable stage III non-small cell lung cancer (NSCLC). This prompted us to search real-world data (RWD) to better understand diagnosis and treatment patterns, and outcomes. METHODS This non-interventional observational study used a unique, novel algorithm for big data analysis to collect and assess anonymized patient electronic medical records from a clinical data warehouse (CDW) over a 10-year period to capture real-world patterns of diagnosis, treatment, and outcomes of stage III NSCLC patients. We describe real-world patterns of diagnosis and treatment of patients with newly-diagnosed stage III NSCLC, and patients' characteristics, and assessment of treatment outcomes. RESULTS We analyzed clinical variables from 23,735 NSCLC patients. Stage III patients (N = 4138, 18.2 %) were diagnosed as IIIA (N = 2,547, 11.2 %) or IIIB (N = 1,591. 7.0 %). Treated stage III patients (N = 2530, 61.1 %) had a median age of 64.2 years, were mostly male (78.5 %) and had an ECOG performance status of 1 (65.2 %). Treatment comprised curative-intent surgery (N = 1,254, 49.6 %) with 705 receiving neoadjuvant therapy; definitive CRT (N = 648, 25.6 %); palliative CT (N = 270, 10.7 %), or thoracic RT (N = 170, 6.7 %). Median OS (range) for neoadjuvant, surgery, CRT, palliative chemotherapy, lung RT alone, and supportive care was 49.2 (42.0-56.5), 52.5 (43.1-61.9), 30.3 (26.6-34.0), 14.7 (13.0-16.4), 8.8 (6.2-11.3), and 2.0 (1.0-3.0) months, respectively. CONCLUSIONS This unique in-house algorithm enabled a rapid and comprehensive analysis of big data through a CDW, with daily automatic updates that documented real-world PFS and OS consistent with the published literature, and real-world treatment patterns and clinical outcomes in stage III NSCLC patients.
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Affiliation(s)
- Hyun Ae Jung
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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18
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Kaspar M, Liman L, Ertl M, Fette G, Seidlmayer LK, Schreiber L, Puppe F, Störk S. Unlocking the PACS DICOM Domain for its Use in Clinical Research Data Warehouses. J Digit Imaging 2020; 33:1016-1025. [PMID: 32314069 PMCID: PMC7522145 DOI: 10.1007/s10278-020-00334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Clinical Data Warehouses (DWHs) are used to provide researchers with simplified access to pseudonymized and homogenized clinical routine data from multiple primary systems. Experience with the integration of imaging and metadata from picture archiving and communication systems (PACS), however, is rare. Our goal was therefore to analyze the viability of integrating a production PACS with a research DWH to enable DWH queries combining clinical and medical imaging metadata and to enable the DWH to display and download images ad hoc. We developed an application interface that enables to query the production PACS of a large hospital from a clinical research DWH containing pseudonymized data. We evaluated the performance of bulk extracting metadata from the PACS to the DWH and the performance of retrieving images ad hoc from the PACS for display and download within the DWH. We integrated the system into the query interface of our DWH and used it successfully in four use cases. The bulk extraction of imaging metadata required a median (quartiles) time of 0.09 (0.03–2.25) to 12.52 (4.11–37.30) seconds for a median (quartiles) number of 10 (3–29) to 103 (8–693) images per patient, depending on the extraction approach. The ad hoc image retrieval from the PACS required a median (quartiles) of 2.57 (2.57–2.79) seconds per image for the download, but 5.55 (4.91–6.06) seconds to display the first and 40.77 (38.60–41.63) seconds to display all images using the pure web-based viewer. A full integration of a production PACS with a research DWH is viable and enables various use cases in research. While the extraction of basic metadata from all images can be done with reasonable effort, the extraction of all metadata seems to be more appropriate for subgroups.
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Affiliation(s)
- Mathias Kaspar
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany.
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.
| | - Leon Liman
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Maximilian Ertl
- Service Center Medical Informatics, Würzburg University Hospital, Würzburg, Germany
| | - Georg Fette
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Lea Katharina Seidlmayer
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Laura Schreiber
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Frank Puppe
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
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19
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Giannaris PS, Al-Taie Z, Kovalenko M, Thanintorn N, Kholod O, Innokenteva Y, Coberly E, Frazier S, Laziuk K, Popescu M, Shyu CR, Xu D, Hammer RD, Shin D. Artificial Intelligence-Driven Structurization of Diagnostic Information in Free-Text Pathology Reports. J Pathol Inform 2020; 11:4. [PMID: 32166042 PMCID: PMC7045509 DOI: 10.4103/jpi.jpi_30_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/18/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Free-text sections of pathology reports contain the most important information from a diagnostic standpoint. However, this information is largely underutilized for computer-based analytics. The vast majority of NLP-based methods lack a capacity to accurately extract complex diagnostic entities and relationships among them as well as to provide an adequate knowledge representation for downstream data-mining applications. METHODS In this paper, we introduce a novel informatics pipeline that extends open information extraction (openIE) techniques with artificial intelligence (AI) based modeling to extract and transform complex diagnostic entities and relationships among them into Knowledge Graphs (KGs) of relational triples (RTs). RESULTS Evaluation studies have demonstrated that the pipeline's output significantly differs from a random process. The semantic similarity with original reports is high (Mean Weighted Overlap of 0.83). The precision and recall of extracted RTs based on experts' assessment were 0.925 and 0.841 respectively (P <0.0001). Inter-rater agreement was significant at 93.6% and inter-rated reliability was 81.8%. CONCLUSION The results demonstrated important properties of the pipeline such as high accuracy, minimality and adequate knowledge representation. Therefore, we conclude that the pipeline can be used in various downstream data-mining applications to assist diagnostic medicine.
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Affiliation(s)
- Pericles S. Giannaris
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Zainab Al-Taie
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Computer Science, College of Science for Women, University of Baghdad, Baghdad, Iraq
| | - Mikhail Kovalenko
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Nattapon Thanintorn
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Olha Kholod
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Yulia Innokenteva
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
| | - Emily Coberly
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Shellaine Frazier
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Katsiarina Laziuk
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Mihail Popescu
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Electrical Engineering and Computer Science, College of Engineering, University of Missouri, Columbia, MO 65211, United States
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Chi-Ren Shyu
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Electrical Engineering and Computer Science, College of Engineering, University of Missouri, Columbia, MO 65211, United States
| | - Dong Xu
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Electrical Engineering and Computer Science, College of Engineering, University of Missouri, Columbia, MO 65211, United States
| | - Richard D. Hammer
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Dmitriy Shin
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO 65211, United States
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO 65212, United States
- Department of Electrical Engineering and Computer Science, College of Engineering, University of Missouri, Columbia, MO 65211, United States
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20
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Mudaranthakam DP, Shergina E, Park M, Thompson J, Streeter D, Hu J, Wick J, Gajewski B, Koestler DC, Godwin AK, Jensen RA, Mayo MS. Optimizing Retrieval of Biospecimens Using the Curated Cancer Clinical Outcomes Database (C3OD). Cancer Inform 2019; 18:1176935119886831. [PMID: 31798300 PMCID: PMC6864036 DOI: 10.1177/1176935119886831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 11/16/2022] Open
Abstract
To fully support their role in translational and personalized medicine, biorepositories and biobanks must continue to advance the annotation of their biospecimens with robust clinical and laboratory data. Translational research and personalized medicine require well-documented and up-to-date information, but the infrastructure used to support biorepositories and biobanks can easily be out of sync with the host institution. To assist researchers and provide them with accurate pathological, epidemiological, and bio-molecular data, the Biospecimen Repository Core Facility (BRCF) at the University of Kansas Medical Center (KUMC) merges data from medical records, the tumor registry, and pathology reports using the Curated Cancer Clinical Outcomes Database (C3OD). In this report, we describe the utilization of C3OD to optimally retrieve and dispense biospecimen samples using these 3 data sources and demonstrate how C3OD greatly increases the efficiency of obtaining biospecimen samples for the researchers.
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Affiliation(s)
- Dinesh Pal Mudaranthakam
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - Elena Shergina
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Michele Park
- University of Kansas Cancer Center, Kansas City, KS, USA
| | - Jeffrey Thompson
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - David Streeter
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - Jinxiang Hu
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - Jo Wick
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - Byron Gajewski
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | - Devin C Koestler
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
| | | | - Roy A Jensen
- University of Kansas Cancer Center, Kansas City, KS, USA
| | - Matthew S Mayo
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, Kansas City, KS, USA
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Hooiveld-Noeken J, Fehrmann R, de Vries E, Jalving M. Driving innovation for rare skin cancers: utilizing common tumours and machine learning to predict immune checkpoint inhibitor response. IMMUNO-ONCOLOGY TECHNOLOGY 2019; 4:1-7. [PMID: 35755000 PMCID: PMC9216707 DOI: 10.1016/j.iotech.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/30/2022]
Abstract
Metastatic Merkel cell carcinoma (MCC) and cutaneous squamous cell carcinoma (cSCC) are rare and both show impressive responses to immune checkpoint inhibitor treatment. However, at least 40% of patients do not respond to these expensive and potentially toxic drugs. Development of predictive biomarkers of response and rational, effective combination treatment strategies in these rare, often frail patient populations is challenging. This review discusses the pathophysiology and treatment of MCC and cSCC, with a particular focus on potential biomarkers of response to immunotherapy, and discusses how transfer learning using big data collected from patients with common tumours can be used in combination with deep phenotyping of rare tumours to develop predictive biomarkers and elucidate novel treatment targets. Metastatic Merkel cell carcinoma and cutaneous squamous cell carcinoma are rare tumours. Immunotherapy gives impressive responses but most patients do not survive long term. Small patient numbers prevent extensive biomarker research in clinical trials. Pooled data from common and rare tumours can be used to train neural networks. In rare cancers, neural networks can help identify biomarkers and novel treatment targets.
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Oberst S. Bridging research and clinical care - the comprehensive cancer centre. Mol Oncol 2019; 13:614-618. [PMID: 30628155 PMCID: PMC6396367 DOI: 10.1002/1878-0261.12442] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/14/2018] [Accepted: 12/21/2018] [Indexed: 12/29/2022] Open
Abstract
Comprehensive cancer centres (CCCs) are at the heart of the landscape of cancer research, education and care in Europe. They are vital hubs where the historic gaps in the research to clinical care continuum are bridged. CCCs have established hallmarks, but a greater emphasis is needed in Europe to create more effective CCCs using the partnership model of university medical centres and university research departments and institutes. This review will summarise the organisational structures and processes essential for producing quality outcomes for patients and effectiveness in the translational process. The Organisation of European Cancer Institutes and European Academy of Cancer Sciences have established complementary quality accreditations systems to test the clinical and research excellence of CCCs. The EU should have an ambition to create more CCCs based on university hospitals, for each 5-10 million population and in every Member State.
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Abstract
Background Electronic health record (EHR) based research in oncology can be limited by missing data and a lack of structured data elements. Clinical research data warehouses for specific cancer types can enable the creation of more robust research cohorts. Methods We linked data from the Stanford University EHR with the Stanford Cancer Institute Research Database (SCIRDB) and the California Cancer Registry (CCR) to create a research data warehouse for prostate cancer. The database was supplemented with information from clinical trials, natural language processing of clinical notes and surveys on patient-reported outcomes. Results 11,898 unique prostate cancer patients were identified in the Stanford EHR, of which 3,936 were matched to the Stanford cancer registry and 6153 in the CCR. 7158 patients with EHR data and at least one of SCIRDB and CCR data were initially included in the warehouse. Conclusions A disease-specific clinical research data warehouse combining multiple data sources can facilitate secondary data use and enhance observational research in oncology.
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Khiabanian H, Hirshfield KM, Goldfinger M, Bird S, Stein M, Aisner J, Toppmeyer D, Wong S, Chan N, Dhar K, Gheeya J, Vig H, Hadigol M, Pavlick D, Ansari S, Ali S, Xia B, Rodriguez-Rodriguez L, Ganesan S. Inference of Germline Mutational Status and Evaluation of Loss of Heterozygosity in High-Depth, Tumor-Only Sequencing Data. JCO Precis Oncol 2018; 2018:PO.17.00148. [PMID: 30246169 PMCID: PMC6148761 DOI: 10.1200/po.17.00148] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Inherited germline defects are implicated in up to 10% of human tumors, with particularly well-known roles in breast and ovarian cancers that harbor BRCA1/2-mutated genes. There is also increasing evidence for the role of germline alterations in other malignancies such as colon and pancreatic cancers. Mutations in familial cancer genes can be detected by high throughput sequencing (HTS), when applied to formalin-fixed paraffin-embedded (FFPE) tumor specimens. However, due to often lack of patient-matched control normal DNA and/or low tumor purity, there is limited ability to determine the genomic status of these alterations (germline versus somatic) and to assess the presence of loss of heterozygosity (LOH). These analyses, especially when applied to genes such as BRCA1/2, can have significant clinical implications for patient care. METHODS LOHGIC (LOH-Germline Inference Calculator) is a statistical model selection method to determine somatic-versus-germline status and predict LOH for mutations identified via clinical grade, high-depth, hybrid-capture tumor-only sequencing. LOHGIC incorporates statistical uncertainties inherent to HTS as well as specimen biases in tumor purity estimates, which we use to assess BRCA1/2 mutations in 1,636 specimens sequenced at Rutgers Cancer Institute of New Jersey. RESULTS Evaluation of LOHGIC with available germline sequencing from BRCA1/2 testing, demonstrates 93% accuracy, 100% precision, and 96% recall. This analysis highlights a differential tumor spectrum associated with BRCA1/2 mutations. CONCLUSION LOHGIC can assess LOH status for both germline and somatic mutations. It also can be applied to any gene with candidate, inherited mutations. This approach demonstrates the clinical utility of targeted sequencing in both identifying patients with potential germline alterations in tumor suppressor genes as well as estimating LOH occurrence in cancer cells, which may confer therapeutic relevance.
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Affiliation(s)
- Hossein Khiabanian
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Kim M. Hirshfield
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Mendel Goldfinger
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Simon Bird
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Mark Stein
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Joseph Aisner
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Deborah Toppmeyer
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Serena Wong
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Nancy Chan
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Kalyani Dhar
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Jinesh Gheeya
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Hetal Vig
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Mohammad Hadigol
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Dean Pavlick
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Sepand Ansari
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Siraj Ali
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Bing Xia
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Lorna Rodriguez-Rodriguez
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
| | - Shridar Ganesan
- Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Simon Bird, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Kalyani Dhar, Jinesh Gheeya, Hetal Vig, Mohammad Hadigol, Sepand Ansari, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Cancer Institute of New Jersey, Rutgers University; Hossein Khiabanian, Kim M. Hirshfield, Mendel Goldfinger, Mark Stein, Joseph Aisner, Deborah Toppmeyer, Serena Wong, Nancy Chan, Bing Xia, Lorna Rodriguez-Rodriguez, and Shridar Ganesan, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; and Dean Pavlick and Siraj Ali, Foundation Medicine, Cambridge, MA
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Christensen PA, Ni Y, Bao F, Hendrickson HL, Greenwood M, Thomas JS, Long SW, Olsen RJ. Houston Methodist Variant Viewer: An Application to Support Clinical Laboratory Interpretation of Next-generation Sequencing Data for Cancer. J Pathol Inform 2017; 8:44. [PMID: 29226007 PMCID: PMC5719586 DOI: 10.4103/jpi.jpi_48_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/12/2017] [Indexed: 01/17/2023] Open
Abstract
Introduction Next-generation-sequencing (NGS) is increasingly used in clinical and research protocols for patients with cancer. NGS assays are routinely used in clinical laboratories to detect mutations bearing on cancer diagnosis, prognosis and personalized therapy. A typical assay may interrogate 50 or more gene targets that encompass many thousands of possible gene variants. Analysis of NGS data in cancer is a labor-intensive process that can become overwhelming to the molecular pathologist or research scientist. Although commercial tools for NGS data analysis and interpretation are available, they are often costly, lack key functionality or cannot be customized by the end user. Methods To facilitate NGS data analysis in our clinical molecular diagnostics laboratory, we created a custom bioinformatics tool termed Houston Methodist Variant Viewer (HMVV). HMVV is a Java-based solution that integrates sequencing instrument output, bioinformatics analysis, storage resources and end user interface. Results Compared to the predicate method used in our clinical laboratory, HMVV markedly simplifies the bioinformatics workflow for the molecular technologist and facilitates the variant review by the molecular pathologist. Importantly, HMVV reduces time spent researching the biological significance of the variants detected, standardizes the online resources used to perform the variant investigation and assists generation of the annotated report for the electronic medical record. HMVV also maintains a searchable variant database, including the variant annotations generated by the pathologist, which is useful for downstream quality improvement and research projects. Conclusions HMVV is a clinical grade, low-cost, feature-rich, highly customizable platform that we have made available for continued development by the pathology informatics community.
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Affiliation(s)
- Paul A Christensen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - Yunyun Ni
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA.,Helix, San Carlos, California 94070, USA
| | - Feifei Bao
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - Heather L Hendrickson
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - Michael Greenwood
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - Jessica S Thomas
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - S Wesley Long
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
| | - Randall J Olsen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, Texas, USA
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