Tufve Nyholm1, Caroline Olsson2, Måns Agrup3, Peter Björk4, Thomas Björk-Eriksson5, Giovanna Gagliardi6, Hanne Grinaker7, Adalsteinn Gunnlaugsson8, Anders Gustafsson9, Magnus Gustafsson10, Bengt Johansson11, Stefan Johnsson12, Magnus Karlsson13, Ingrid Kristensen8, Per Nilsson8, Leif Nyström13, Eva Onjukka6, Johan Reizenstein11, Johan Skönevik13, Karin Söderström13, Alexander Valdman14, Björn Zackrisson13, Anders Montelius15. 1. Department of Radiation Sciences, Umeå University, Sweden; Medical Radiation Physics, Department of Immunology, Genetics and Pathology, Uppsala University, Sweden. 2. Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sweden; Regional Cancer Center West, Western Sweden Healthcare Region, Göteborg, Sweden. 3. Department of Oncology, Linköping University Hospital, Sweden. 4. Department of Physics and Biomedical Engineering, Mälar Hospital, Eskilstuna, Sweden. 5. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden. 7. Swedish Radiation Safety Authority, Sweden. 8. Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden. 9. Cureos AB, Uppsala, Sweden. 10. Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden. 11. Department of Oncology, Örebro University Hospital and Örebro University, Sweden. 12. Department of Radiation Physics, Kalmar County Hospital, Sweden. 13. Department of Radiation Sciences, Umeå University, Sweden. 14. Department of Oncology, Karolinska University Hospital, Stockholm, Sweden. 15. Medical Radiation Physics, Department of Immunology, Genetics and Pathology, Uppsala University, Sweden.
Abstract
PURPOSE: To develop an infrastructure for structured and automated collection of interoperable radiation therapy (RT) data into a national clinical quality registry. MATERIALS AND METHODS: The present study was initiated in 2012 with the participation of seven of the 15 hospital departments delivering RT in Sweden. A national RT nomenclature and a database for structured unified storage of RT data at each site (Medical Information Quality Archive, MIQA) have been developed. Aggregated data from the MIQA databases are sent to a national RT registry located on the same IT platform (INCA) as the national clinical cancer registries. RESULTS: The suggested naming convention has to date been integrated into the clinical workflow at 12 of 15 sites, and MIQA is installed at six of these. Involvement of the remaining 3/15 RT departments is ongoing, and they are expected to be part of the infrastructure by 2016. RT data collection from ARIA®, Mosaiq®, Eclipse™, and Oncentra® is supported. Manual curation of RT-structure information is needed for approximately 10% of target volumes, but rarely for normal tissue structures, demonstrating a good compliance to the RT nomenclature. Aggregated dose/volume descriptors are calculated based on the information in MIQA and sent to INCA using a dedicated service (MIQA2INCA). Correct linkage of data for each patient to the clinical cancer registries on the INCA platform is assured by the unique Swedish personal identity number. CONCLUSIONS: An infrastructure for structured and automated prospective collection of syntactically interoperable RT data into a national clinical quality registry for RT data is under implementation. Future developments include adapting MIQA to other treatment modalities (e.g. proton therapy and brachytherapy) and finding strategies to harmonize structure delineations. How the RT registry should comply with domain-specific ontologies such as the Radiation Oncology Ontology (ROO) is under discussion.
PURPOSE: To develop an infrastructure for structured and automated collection of interoperable radiation therapy (RT) data into a national clinical quality registry. MATERIALS AND METHODS: The present study was initiated in 2012 with the participation of seven of the 15 hospital departments delivering RT in Sweden. A national RT nomenclature and a database for structured unified storage of RT data at each site (Medical Information Quality Archive, MIQA) have been developed. Aggregated data from the MIQA databases are sent to a national RT registry located on the same IT platform (INCA) as the national clinical cancer registries. RESULTS: The suggested naming convention has to date been integrated into the clinical workflow at 12 of 15 sites, and MIQA is installed at six of these. Involvement of the remaining 3/15 RT departments is ongoing, and they are expected to be part of the infrastructure by 2016. RT data collection from ARIA®, Mosaiq®, Eclipse™, and Oncentra® is supported. Manual curation of RT-structure information is needed for approximately 10% of target volumes, but rarely for normal tissue structures, demonstrating a good compliance to the RT nomenclature. Aggregated dose/volume descriptors are calculated based on the information in MIQA and sent to INCA using a dedicated service (MIQA2INCA). Correct linkage of data for each patient to the clinical cancer registries on the INCA platform is assured by the unique Swedish personal identity number. CONCLUSIONS: An infrastructure for structured and automated prospective collection of syntactically interoperable RT data into a national clinical quality registry for RT data is under implementation. Future developments include adapting MIQA to other treatment modalities (e.g. proton therapy and brachytherapy) and finding strategies to harmonize structure delineations. How the RT registry should comply with domain-specific ontologies such as the Radiation Oncology Ontology (ROO) is under discussion.
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