Holz Christian, Kessler Torsten, Dugas Martin, Varghese Julian
Institute of Medical Informatics, University of Münster, Münster, Germany.
Department of Medicine A, University Hospital of Münster, Münster, Germany.
JMIR Med Inform. 2019 Aug 12;7(3):e13554. doi: 10.2196/13554.
For cancer domains such as acute myeloid leukemia (AML), a large set of data elements is obtained from different institutions with heterogeneous data definitions within one patient course. The lack of clinical data harmonization impedes cross-institutional electronic data exchange and future meta-analyses.
This study aimed to identify and harmonize a semantic core of common data elements (CDEs) in clinical routine and research documentation, based on a systematic metadata analysis of existing documentation models.
Lists of relevant data items were collected and reviewed by hematologists from two university hospitals regarding routine documentation and several case report forms of clinical trials for AML. In addition, existing registries and international recommendations were included. Data items were coded to medical concepts via the Unified Medical Language System (UMLS) by a physician and reviewed by another physician. On the basis of the coded concepts, the data sources were analyzed for concept overlaps and identification of most frequent concepts. The most frequent concepts were then implemented as data elements in the standardized format of the Operational Data Model by the Clinical Data Interchange Standards Consortium.
A total of 3265 medical concepts were identified, of which 1414 were unique. Among the 1414 unique medical concepts, the 50 most frequent ones cover 26.98% of all concept occurrences within the collected AML documentation. The top 100 concepts represent 39.48% of all concepts' occurrences. Implementation of CDEs is available on a European research infrastructure and can be downloaded in different formats for reuse in different electronic data capture systems.
Information management is a complex process for research-intense disease entities as AML that is associated with a large set of lab-based diagnostics and different treatment options. Our systematic UMLS-based analysis revealed the existence of a core data set and an exemplary reusable implementation for harmonized data capture is available on an established metadata repository.
对于急性髓系白血病(AML)等癌症领域,在一个患者病程中会从不同机构获取大量数据元素,且数据定义存在异质性。临床数据缺乏统一标准阻碍了跨机构的电子数据交换以及未来的荟萃分析。
本研究旨在基于对现有文档模型的系统元数据分析,识别并统一临床常规和研究文档中通用数据元素(CDE)的语义核心。
两所大学医院的血液科医生收集并审查了有关AML常规文档及若干临床试验病例报告表的相关数据项列表。此外,还纳入了现有登记处和国际建议。一名医生通过统一医学语言系统(UMLS)将数据项编码为医学概念,另一名医生进行审核。基于编码后的概念,分析数据源的概念重叠情况并识别最常见的概念。然后,临床数据交换标准协会将最常见的概念作为数据元素以操作数据模型的标准化格式实施。
共识别出3265个医学概念,其中1414个是唯一的。在这1414个唯一医学概念中,最常见的50个概念占所收集AML文档中所有概念出现次数的26.98%。前100个概念占所有概念出现次数的39.48%。CDE的实施可在欧洲研究基础设施上获取,并可下载为不同格式以便在不同的电子数据捕获系统中重复使用。
对于像AML这样与大量基于实验室的诊断和不同治疗选择相关的研究密集型疾病实体,信息管理是一个复杂的过程。我们基于UMLS的系统分析揭示了核心数据集的存在,并且在一个既定的元数据存储库中提供了用于统一数据捕获的示例性可重复使用实施方案。