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CC BY-NC-ND 4.0 · Appl Clin Inform 2018; 09(02): 377-390
DOI: 10.1055/s-0038-1651497
Research Article
Schattauer GmbH Stuttgart

Integrating Multimodal Radiation Therapy Data into i2b2

Eric Zapletal
1   Department of Medical Informatics, Biostatistics, and Public Health, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
,
Jean-Emmanuel Bibault
2   Department of Radiation Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
3   INSERM UMR 1138 Eq22, Cordeliers Research Centre, Paris Descartes University, Paris, France
,
Philippe Giraud
2   Department of Radiation Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
,
Anita Burgun
1   Department of Medical Informatics, Biostatistics, and Public Health, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
3   INSERM UMR 1138 Eq22, Cordeliers Research Centre, Paris Descartes University, Paris, France
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Publication History

12 December 2017

07 April 2018

Publication Date:
30 May 2018 (online)

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Abstract

Background Clinical data warehouses are now widely used to foster clinical and translational research and the Informatics for Integrating Biology and the Bedside (i2b2) platform has become a de facto standard for storing clinical data in many projects. However, to design predictive models and assist in personalized treatment planning in cancer or radiation oncology, all available patient data need to be integrated into i2b2, including radiation therapy data that are currently not addressed in many existing i2b2 sites.

Objective To use radiation therapy data in projects related to rectal cancer patients, we assessed the feasibility of integrating radiation oncology data into the i2b2 platform.

Methods The Georges Pompidou European Hospital, a hospital from the Assistance Publique – Hôpitaux de Paris group, has developed an i2b2-based clinical data warehouse of various structured and unstructured clinical data for research since 2008. To store and reuse various radiation therapy data—dose details, activities scheduling, and dose-volume histogram (DVH) curves—in this repository, we first extracted raw data by using some reverse engineering techniques and a vendor's application programming interface. Then, we implemented a hybrid storage approach by combining the standard i2b2 “Entity-Attribute-Value” storage mechanism with a “JavaScript Object Notation (JSON) document-based” storage mechanism without modifying the i2b2 core tables. Validation was performed using (1) the Business Objects framework for replicating vendor's application screens showing dose details and activities scheduling data and (2) the R software for displaying the DVH curves.

Results We developed a pipeline to integrate the radiation therapy data into the Georges Pompidou European Hospital i2b2 instance and evaluated it on a cohort of 262 patients. We were able to use the radiation therapy data on a preliminary use case by fetching the DVH curve data from the clinical data warehouse and displaying them in a R chart.

Conclusion By adding radiation therapy data into the clinical data warehouse, we were able to analyze radiation therapy response in cancer patients and we have leveraged the i2b2 platform to store radiation therapy data, including detailed information such as the DVH to create new ontology-based modules that provides research investigators with a wider spectrum of clinical data.

Keywords

data warehouse - radiation therapy - software validation

Protection of Human and Animal Subjects

This study from which the data were extracted was approved by the IRB and ethics committee CPP Ile-de-France II (IRB Committee # 00001072, study reference # CDW_2015_0024). Patients consent to participate to the study was implicit if refusal was not expressly stated. The HEGP CDW has been declared to the French CNIL regulatory commission for data privacy (# 1695855 v 0 ; 2013/08/28).