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.
Int J Environ Res Public Health. 2023 Jan 16;20(2):1645. doi: 10.3390/ijerph20021645.
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.
大数据和人工智能可以深刻改变医疗实践，特别是在肿瘤学领域。综合癌症中心在这场革命中扮演着重要的角色。为了推进我们的知识并加速癌症研究，迫切需要通过开发强大有效的数据仓库来利用这一数据资源。通过法国综合癌症中心的近期经验，本文表明，尽管使用医院数据仓库可以通过考虑多源、多领域和多尺度的数据来为知识和患者带来进步，但它仍然引发了一些技术、组织和法律问题，这些问题仍需要解决。本文的目标有三个：1. 提供有关公共卫生利益的发展洞察，以综合癌症中心全面管理癌症患者；2. 阐明从内部构建数据的挑战；3. 概述实施的法律问题，以开展真实世界证据研究。为了实现目标 1，本文首先讨论了综合方法管理癌症的相关性，以及数据仓库作为实现这一目标的有力工具。为了解决目标 2，我们进行了文献综述，筛选了截至 2022 年底在法国综合癌症中心使用数据仓库的 PubMed 和 Google Scholar 上发表的文章。选择了七篇专门讨论数据结构问题的出版物。为了实现目标 3，我们介绍并评论了法国和欧洲在卫生数据、医院数据仓库和真实世界证据领域的主要立法和监管方面的情况。
