scholarly journals Improving Cancer Data Interoperability: The Promise of the Minimal Common Oncology Data Elements (mCODE) Initiative

2020 ◽  
pp. 993-1001
Author(s):  
Travis J. Osterman ◽  
May Terry ◽  
Robert S. Miller
Keyword(s):  
Work Group ◽  
Care Delivery ◽  
Patient Data ◽  
Data Interoperability ◽  
Cancer Data ◽  
Patients With Cancer ◽  
Health Level 7 ◽  
Negative Comments ◽  
Data Elements ◽  
High Level

PURPOSE Because of expanding interoperability requirements, structured patient data are increasingly available in electronic health records. Many oncology data elements (eg, staging, biomarkers, documentation of adverse events and cancer outcomes) remain challenging. The Minimal Common Oncology Data Elements (mCODE) project is a consensus data standard created to facilitate transmission of data of patients with cancer. METHODS In 2018, mCODE was developed through a work group convened by ASCO, including oncologists, informaticians, researchers, and experts in terminologies and standards. The mCODE specification is organized by 6 high-level domains: patient, laboratory/vital, disease, genomics, treatment, and outcome. In total, 23 mCODE profiles are composed of 90 data elements. RESULTS A conceptual model was published for public comment in January 2019 and, after additional refinement, the first public version of the mCODE (version 0.9.1) Fast Healthcare Interoperability Resources (FHIR) implementation guide (IG) was presented at the ASCO Annual Meeting in June 2019. The specification was approved for balloting by Health Level 7 International (HL7) in August 2019. mCODE passed the HL7 ballot in September 2019 with 86.5% approval. The mCODE IG authors worked with HL7 reviewers to resolve all negative comments, leading to a modest expansion in the number of data elements and tighter alignment with FHIR and other HL7 conventions. The mCODE version 1.0 FHIR IG Standard for Trial Use was formally published on March 18, 2020. CONCLUSION The mCODE project has the potential to offer tremendous benefits to cancer care delivery and research by creating an infrastructure to better share patient data. mCODE is available free from www.mCODEinitiative.org . Pilot implementations are underway, and a robust community of stakeholders has been assembled across the oncology ecosystem.

Establishing the common oncology data model for the national biobank consortium of Taiwan.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19283-e19283
Author(s):  
Yang Yi-Hsin ◽  
Li-Tzong Chen ◽  
Shiu-Feng Huang
Keyword(s):  
National Health ◽  
Real World ◽  
Data Model ◽  
Data Science ◽  
Common Data Model ◽  
Data Interoperability ◽  
Cancer Data ◽  
Common Definition ◽  
The Common ◽  
Data Elements

e19283 Background: Taiwan has 32 biobanks under Government’ governance. The Ministry of Health and Welfare have established a National Biobank Consortium of Taiwan to unify the specimen quality and the medical record database. The total recruited participants exceed 350,000. The National Health Research Institutes in Taiwan hold the responsibility of establish a common data model for aggregating data elements from electronic health records (EHRs) of institutes through direct feeds. The goals are to assemble a set of common oncology data elements and to facilitate cancer data interoperability for patient care and research across institutes of Biobank Consortium. Methods: We first conduct a thorough review of available EHR data elements for patient characteristics, diagnosis/staging, treatments, laboratory results, vital signs and outcomes. The data dictionary was organized based on HL7 FHIR and also included data elements from Taiwan Cancer Registry (TCR) and National Health Insurance (NHI) Program, which the common definition has already been established and implemented for years. Data elements suggested by ASCO CancerLinQ and minimal Common Oncology Data Elements (mCODE) are also referenced during planning. The final common model was then reviewed by a panel of experts consisting oncologists as well as data science specialists. Results: There are finally 9 data tables with 281 data elements, in which 248 of them are from the routinely uploaded data elements to government agencies (TCR & NHI) and 33 elements are collected with partial common definition among institutes. There are 164 data elements which are to be collected one observation per case, while 117 elements will be accumulated periodically. Conclusions: A comprehensive understanding of genetics, phenotypes, disease variation as well as treatment responses is crucial to fulfill the needs of real-world studies, which potentially would lead to personalized treatment and drug development. At the first stage of this project, we aim to accumulate available EHR structured data elements and to maintain sufficient cancer data quality. Consequently, the database can provide real-world evidence to promote evidence-based & data-driven cancer care.

Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18609-e18609
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Sandy Srinivas ◽  
Sarah Garrigues ◽  
Eben Lloyd Rosenthal ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Advanced Practice ◽  
Curative Surgery ◽  
Time Points ◽  
Patients With Cancer ◽  
Provider Perspectives ◽  
Significant Difference ◽  
The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

scholarly journals The effect of preceptorship on nurses' training and preparation with implications for Qatar: A literature review

2018 ◽  
Vol 8 (7) ◽  
pp. 44 ◽  
Author(s):  
Hajer Arbabi ◽  
Jessie Johnson ◽  
Daniel Forgrave
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Organizational Support ◽  
Care Delivery ◽  
Health Centers ◽  
Primary Health ◽  
Newly Graduated Nurses ◽  
Level Of Training ◽  
High Level

Background and objective: The Primary Health Care Corporation in Qatar was established in 2012 and is comprised of 23 Health Centers. One of its goals is to create excellence in its workforce. A preceptorship program needs to be initiated at the Primary Health Care Corporation to ensure a high level of training for its nurses. The purpose of these preceptorship programs is to ensure nurses are equipped to carry out Qatar’s National Health Strategy and in doing so the Primary Health Care Corporation has this as its goal. This study amis to assess the effectiveness of preceptorship program models that can eventually be used for adoption as training programs for nurses in Health Centers in Qatar.Methods: A literature review of twenty articles published between 2006 and 2017 that focused on different models of preceptorship programs was conducted. The Mixed Methods Appraisal Tool was used to assess the quality of these studies. The data was analyzed by categorizing the included articles in a matrix sheet based on study design.Results and conclusions: Preceptorship programs are effective in four key areas: increasing nursing knowledge, supporting effective and safe care delivery by newly graduated nurses, increasing organizational support, and decreasing turnover rate and cost. 

Where Patients With Cancer Die: A Population-Based Study, 1990 to 2012

2018 ◽  
Vol 34 (4) ◽  
pp. 224-231 ◽  
Author(s):  
Roger W. Hunt ◽  
Katina D’Onise ◽  
Anh-Minh Thi Nguyen ◽  
Kamalesh Venugopal
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Care Delivery ◽  
Young Patients ◽  
Population Based ◽  
Place Of Death ◽  
Patients With Cancer ◽  
Metropolitan Hospital ◽  
Care Models ◽  
At Home

Aims:To describe changes in the place of death of patients with cancer from 1990 to 2012, and to identify issues for their end-of-life care.Materials and Methods:Population-based descriptive study, with analyses of place of death patterns, using the South Australian Cancer Registry records of 86 257 patients with cancer who died from 1990 to 2012.Results:From 1990 to 2012, the proportion of cancer deaths in hospital decreased from 63.4% to 50.9%, and in nursing homes increased from 8.2% to 22.5%. After the year 2000, the proportions in hospices and at home were both below 15%. Multivariate analyses showed that young patients with cancer were more likely to die in a hospice or at home, compared to elderly patients with cancer who were more likely to die in a nursing home; the likelihood of dying in a hospice increased with socioeconomic status; patients with a short survival time or a hematological malignancy were more likely to die in a metropolitan hospital.Conclusions:Compared to most other countries, the proportion of cancer deaths at home was low, and many patients would not have died at their preferred place. The trend for more cancer deaths to occur in nursing homes is likely to continue, but nursing homes generally lack the resources and skilled staff to provide quality palliative care. Models of palliative care delivery should take account of patient preferences, the growth of terminal cancer care in nursing homes, and apparent inequities.

scholarly journals Postmarketing Safety Study Tool: A Web Based, Dynamic, and Interoperable System for Postmarketing Drug Surveillance Studies

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
A. Anil Sinaci ◽  
Gokce B. Laleci Erturkmen ◽  
Suat Gonul ◽  
Mustafa Yuksel ◽  
Paolo Invernizzi ◽  
...  
Keyword(s):  
Clinical Research ◽  
Real Life ◽  
Critical Factor ◽  
Drug Surveillance ◽  
Safety Study ◽  
Data Interoperability ◽  
Common Data Elements ◽  
Lombardy Region ◽  
Research Activities ◽  
Data Elements

Postmarketing drug surveillance is a crucial aspect of the clinical research activities in pharmacovigilance and pharmacoepidemiology. Successful utilization of available Electronic Health Record (EHR) data can complement and strengthen postmarketing safety studies. In terms of the secondary use of EHRs, access and analysis of patient data across different domains are a critical factor; we address this data interoperability problem between EHR systems and clinical research systems in this paper. We demonstrate that this problem can be solved in an upper level with the use of common data elements in a standardized fashion so that clinical researchers can work with different EHR systems independently of the underlying information model. Postmarketing Safety Study Tool lets the clinical researchers extract data from different EHR systems by designing data collection set schemas through common data elements. The tool interacts with a semantic metadata registry through IHE data element exchange profile. Postmarketing Safety Study Tool and its supporting components have been implemented and deployed on the central data warehouse of the Lombardy region, Italy, which contains anonymized records of about 16 million patients with over 10-year longitudinal data on average. Clinical researchers in Roche validate the tool with real life use cases.

Altered Tryptophan and Neopterin Metabolism In Cancer Patients

Pteridines ◽  
1998 ◽  
Vol 9 (1) ◽  
pp. 29-32
Author(s):  
Hiromi Iwagaki ◽  
Akio Hizuta ◽  
Yasuki Nitta ◽  
Noriaki Tanaka
Keyword(s):  
Nicotinic Acid ◽  
Cancer Patients ◽  
Immune Activation ◽  
Cancer Cachexia ◽  
Healthy Controls ◽  
Patients With Cancer ◽  
Time Period ◽  
Ifn Γ ◽  
Acid Pathway ◽  
High Level

Summary Plasma 5-hydroxytryptamine (serotonin), tryptophan and neopterin levels were measured in patients with depressive cancer cachexia and in healthy controls during the same time period. Patients with advanced cancers had significantly raised neopterin, a marker of endogenous gamma-interferon (IFN-γ) production, but decreased serotonin and tryptophan levels. IFN-γ induces a high level of indoleamine dioxvgenase (IDO), a tryptophan degrading enzyme, which in turn increases metabolism along the tryptophan- nicotinic acid pathway, resulting in decreased synthesis of serotonin. These results suggest that persistent immune activation occur in patients with cancer cachexia, resulting in disorders involving tryptophan metabolism.

scholarly journals The use of training technology tools as the basis for its successful implementation in intra-organization training

2021 ◽  
Vol 11 (3) ◽  
pp. 206-215 ◽  
Author(s):  
A. V. Cherepanov ◽  
G. A. Rekhtina
Keyword(s):  
Work Group ◽  
Successful Implementation ◽  
Training Methods ◽  
Simulation Games ◽  
Self Presentation ◽  
Training Support ◽  
Iterative Model ◽  
Technology Tools ◽  
External Conditions ◽  
High Level

The problem fields of research in the framework of the topic are the lack of classification of training methods in intra-organization training, the insufficient quality of the use of tools in the practice of intra-organization training, as well as the use of tools for evaluating and analyzing training activities. The highlighted aspects allowed us to determine the relevant vectors of the research: the competence of the coach, the systematization of training methods and techniques, the features of the use of the tools, the methodology of the tools for evaluation of training sessions. The most important characteristic of the competence of a corporate coach is the possession of the training technology tools at a high level. The article stands out the main competences of a corporate coach, such as focus on results, effective communication, effective self-presentation, persuasion and influence, confidence and stress resistance, creating a motivating educational environment. The authors pay particular attention to the phenomenon of pedagogical artistry, internal and external conditions of its development. The article introduces the basic training techniques (informational, stimulation, exercises for practical performance of work, group-dynamic exercises) and related training methods into the system. The authors consider the criteria and limitations that a trainer should to take into account when choosing training technology tools. The article introduces distinctions of tools when considering their arsenal (planning tools; direct implementation of the process; control (monitoring), evaluation and analysis of the results; post-training support). The authors indicate the following features of the use of training technology tools in intra-organization training: the formation of target guidelines for each stage of training implementation; determining tasks and the algorithm for training implementation; drawing up a training program; chronological planning of training units; planning of the necessary methodical support of training units; compliance with the principle of training planning based on an iterative model with one or more contours; the use of business and simulation games, exercises and tasks; using multiple studies scenarios for conducting classes; presenting information depending on the features of its perception; taking into account the target audience; taking into account the age characteristics of the audience, etc.

scholarly journals Prevalence of anxiety disorder among workers with cancer in Amman, Jordan

2020 ◽  
Author(s):  
Abdel Rahman Aref Ali Abu Shreea ◽  
Lee Khuan ◽  
Sharifah Norkhadijah Syed Ismail ◽  
Nasrudin Subhi ◽  
Sobuh (Moh’d Sobhi) Ahmad Abu-Shanab ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Marital Status ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sample Population ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Cancer Data ◽  
Patients With Cancer ◽  
Significant Difference

AbstractIntroductionCancer is now being recognised as a long term conditions due to advances in treatments that increase the survival rate of patients with cancer to as long as 10 years from the time of the disease. Anxiety is among the commonly discovered psychiatric illness in patients with cancer and is often neglected. Approximately 10% of patients with cancer are affected with anxiety worldwide. Hence, this study was aimed to determine the prevalence of anxiety disorder and its associated factors among workers with cancer in Jordanian population.MethodsA cross-sectional study was conducted at the King Husain Cancer Centre (KHCC) in Amman, Jordan. Proportional sampling technique was used to obtain the sample population of 355 workers with cancer. Data were collected through self-administered Generalized Anxiety Disorder (GAD-7) questionnaire and analyses were carried out using SPSS version 25.ResultsResponse rate of 100% were obtained from the participants. Prevalence of anxiety disorder among workers with cancer was recorded at 20.8% with male (23.1%) having the higher prevalence rate than female (17.3%) workers with cancers. A significant difference in anxiety between marital status (p=0.025), types of cancer (p=0.001), treatment types (p=0.024) were observed. A multiple regression was run to predict anxiety disorder from marital status, type of cancer and treatment types. These variables statistically significantly predicted anxiety disorder [F(3, 351) = 8.117, p < .001, R2 = 0.225].ConclusionThere is high prevalent of anxiety disorder among workers with cancer in Jordan. Predictors of anxiety among workers with cancer were also identified in this report.

scholarly journals What Matters to Us: Impact of Telemedicine During the Pandemic in the Care of Patients With Sarcoma Across Scotland

2021 ◽  
pp. 1067-1073
Author(s):  
Holly M. McCabe ◽  
Alannah Smrke ◽  
Fiona Cowie ◽  
Jeff White ◽  
Peter Chong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Mixed System ◽  
Specialist Care ◽  
Team Members ◽  
Delivery Of Care ◽  
Face To Face ◽  
Patients With Cancer ◽  
Rapid Changes ◽  
Regular Practice ◽  
Survey Questionnaires

PURPOSE In Scotland, approximately 350 sarcoma cases are diagnosed per year and treated in one of the five specialist centers. Many patients are required to travel long distances to access specialist care. The COVID-19 pandemic brought a number of rapid changes into the care for patients with cancer, with increasing utilization of telemedicine. We aimed to evaluate how the utilization of telemedicine affects professionals and patients across Scotland and care delivery, at the Beatson West of Scotland Cancer Centre Sarcoma Unit. METHODS Between June 8 and August 25, 2020, we invited patients and professional sarcoma multidisciplinary team members to participate in separate online anonymous survey questionnaires, to assess their attitudes toward telemedicine. Data were extracted, and descriptive statistics were performed. RESULTS Patient satisfaction (n = 64) with telemedicine was high (mean = 9.4/10) and comparable with traditional face-to-face appointments (mean = 9.5/10). Patients were receptive to the use of telemedicine in certain situations, with patients strongly opposed to being told bad news via telemedicine (88%). Providers recommended the use of telemedicine in certain patient populations and reported largely equivalent workloads when compared with traditional consultations. Providers reported that telemedicine should be integrated into regular practice (66%), with patients echoing this indicating a preference for a majority of telemedicine appointments (57%). CONCLUSION Telemedicine in sarcoma care is favorable from both clinician and patient perspectives. Utilization of telemedicine for patients with rare cancers such as sarcomas is an innovative approach to the delivery of care, especially considering the time and financial pressures on patients who often live a distance away from specialist centers. Patients and providers are keen to move toward a more flexible, mixed system of care.

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