BMC Med Inform Decis Mak - CMDX?-based single source information system for simplified quality management and clinical research in prostate cancer.


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CKGROUND: Histopathological evaluation of prostatectomy specimens is crucial to decision-making and prediction of patient outcomes in prostate cancer (PCa). Topographical information regarding PCa extension and positive surgical margins (PSM) is essential for clinical routines, quality assessment, and research. However, local hospital information systems (HIS) often do not support the documentation of such information. Therefore, we investigated the feasibility of integrating a cMDX-based pathology report including topographical information into the clinical routine with the aims of obtaining data, performing analysis and generating heat maps in a timely manner, while avoiding data redundancy.METHODS: We analyzed the workflow of the histopathological evaluation documentation process. We then developed a concept for a pathology report based on a cMDX data model facilitating the topographical documentation of PCa and PSM; the cMDX SSIS is implemented within the HIS of University Hospital Muenster. We then generated a heat map of PCa extension and PSM using the data. Data quality was assessed by measuring the data completeness of reports for all cases, as well as the source-to-database error. We also conducted a prospective study to compare our proposed method with recent retrospective and paper-based studies according to the time required for data analysis.RESULTS: We identified 30 input fields that were applied to the cMDX-based data model and the electronic report was integrated into the clinical workflow. Between 2010 and 2011, a total of 259 reports were generated with 100% data completeness and a source-to-database error of 10.3 per 10,000 fields. These reports were directly reused for data analysis, and a heat map based on the data was generated. PCa was mostly localized in the peripheral zone of the prostate. The mean relative tumor volume was 16.6%. The most PSM were localized in the apical region of the prostate. In the retrospective study, 1623 paper-based reports were transferred to cMDX reports; this process took 15 ? 2 minutes per report. In a paper-based study, the analysis data preparation required 45 ? 5 minutes per report.CONCLUSIONS: cMDX SSIS can be integrated into the local HIS and provides clinical routine data and timely heat maps for quality assessment and research purposes.

Resumo Limpo

ckground histopatholog evalu prostatectomi specimen crucial decisionmak predict patient outcom prostat cancer pca topograph inform regard pca extens posit surgic margin psm essenti clinic routin qualiti assess research howev local hospit inform system often support document inform therefor investig feasibl integr cmdxbase patholog report includ topograph inform clinic routin aim obtain data perform analysi generat heat map time manner avoid data redundancymethod analyz workflow histopatholog evalu document process develop concept patholog report base cmdx data model facilit topograph document pca psm cmdx ssis implement within univers hospit muenster generat heat map pca extens psm use data data qualiti assess measur data complet report case well sourcetodatabas error also conduct prospect studi compar propos method recent retrospect paperbas studi accord time requir data analysisresult identifi input field appli cmdxbase data model electron report integr clinic workflow total report generat data complet sourcetodatabas error per field report direct reus data analysi heat map base data generat pca most local peripher zone prostat mean relat tumor volum psm local apic region prostat retrospect studi paperbas report transfer cmdx report process took minut per report paperbas studi analysi data prepar requir minut per reportconclus cmdx ssis can integr local provid clinic routin data time heat map qualiti assess research purpos

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