A Step Forward in Cancer Informatics—It Is Mandatory to Make Guidelines Machine Readable
Abstract
Clinical guidelines are general recommendations for practicing clinicians regarding prevention, diagnosis and treatment of a given disease. One of the most comprehensive and used guidelines are developed and regularly updated by the National Comprehensive Cancer Network (NCCN). Guidelines are readily available for download in portable document format (PDF). A machine-readable representation of NCCN guidelines is currently not available. In this writing, we argue on the necessity that clinical guidelines should be published in a machine-readable format. After review of the available literature, we describe the most important achievements in the field. Publication of guidelines in a machine-readable form may also be beneficial for other scientific and technical disciplines.
References
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22. Shahar Y, Miksch S, Johnson P. An intention-based language for representing clinical guidelines. Proc AMIA Annu Fall Symp. 1996:592-6. PubMed PMID: 8947735; PubMed Central PMCID: PMCPMC2233124.
23. Shahar Y, Shalom E, Mayaffit A, Young O, Galperin M, Martins S, et al., editors. A distributed, collaborative, structuring model for a clinical-guideline digital-library. AMIA Annual Symposium Proceedings; 2003: American Medical Informatics Association.
24. Shahar Y, Young O, Shalom E, Mayaffit A, Moskovitch R, Hessing A, et al. The Digital electronic Guideline Library (DeGeL): a hybrid framework for representation and use of clinical guidelines. Stud Health Technol Inform. 2004;101:147-51. PubMed PMID: 15537218.
25. Johnson PD, Tu S, Booth N, Sugden B, Purves IN. Using scenarios in chronic disease management guidelines for primary care. Proc AMIA Symp. 2000:389-93. PubMed PMID: 11079911; PubMed Central PMCID: PMCPMC2244127.
26. Tu SW, Musen MA. A flexible approach to guideline modeling. Proc AMIA Symp. 1999:420-4. PubMed PMID: 10566393; PubMed Central PMCID: PMCPMC2232509.
27. Peleg M, Boxwala AA, Ogunyemi O, Zeng Q, Tu S, Lacson R, et al. GLIF3: the evolution of a guideline representation format. Proc AMIA Symp. 2000:645-9. PubMed PMID: 11079963; PubMed Central PMCID: PMCPMC2243832.
28. Hripcsak G. Arden Syntax for Medical Logic Modules. MD Comput. 1991;8(2):76, 8. PubMed PMID: 2038238.
29. Kuhn RA, Reider RS. A C++ framework for developing Medical Logic Modules and an Arden Syntax compiler. Comput Biol Med. 1994;24(5):365-70. PubMed PMID: 7705067.
30. Jenders RA, Dasgupta B. Assessment of a knowledge-acquisition tool for writing Medical Logic Modules in the Arden Syntax. Proc AMIA Annu Fall Symp. 1996:567-71. PubMed PMID: 8947730; PubMed Central PMCID: PMCPMC2233222.
31. Choi J, Bakken S, Lussier YA, Mendonca EA. Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programmingexpressions. Comput Inform Nurs. 2006;24(4):220-5. PubMed PMID: 16849918; PubMed Central PMCID: PMCPMC2883181.
2. Incorporated AS. Document Management - Portable Document Format - Part 1 [Internet]. Internet: Adobe Systems Incorporated; 2008 [cited 2018 08.02.2018]. Available from: https://www.adobe.com/content/dam/acom/en/devnet/pdf/pdfs/PDF32000_2008.pdf.
3. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758-65. doi: 10.1200/JCO.2008.20.8983. PubMed PMID: 19403886.
4. Schilsky RL, Michels DL, Kearbey AH, Yu PP, Hudis CA. Building a rapid learning health care system for oncology: the regulatory framework of CancerLinQ. J Clin Oncol. 2014;32(22):2373-9. doi: 10.1200/JCO.2014.56.2124. PubMed PMID: 24912897.
5. Shah A, Stewart AK, Kolacevski A, Michels D, Miller R. Building a Rapid Learning Health Care System for Oncology: Why CancerLinQ Collects Identifiable Health Information to Achieve Its Vision. J Clin Oncol. 2016;34(7):756-63. doi: 10.1200/JCO.2015.65.0598. PubMed PMID: 26755519.
6. Waldron D. Cancer genomics: A multi-layer omics approach to cancer. Nature reviews Genetics. 2016;17(8):436-7. doi: 10.1038/nrg.2016.95. PubMed PMID: 27418154.
7. van der Velden DL, van Herpen CML, van Laarhoven HWM, Smit EF, Groen HJM, Willems SM, et al. Molecular Tumor Boards: current practice and future needs. Ann Oncol. 2017;28(12):3070-5. doi: 10.1093/annonc/mdx528. PubMed PMID: 29045504.
8. Parker BA, Schwaederle M, Scur MD, Boles SG, Helsten T, Subramanian R, et al. Breast Cancer Experience of the Molecular Tumor Board at the University of California, San Diego Moores Cancer Center. J Oncol Pract. 2015;11(6):442-9. doi: 10.1200/JOP.2015.004127. PubMed PMID: 26243651.
9. Bardia A, Iafrate JA, Sundaresan T, Younger J, Nardi V. Metastatic Breast Cancer With ESR1 Mutation: Clinical Management Considerations From the Molecular and Precision Medicine (MAP) Tumor Board at Massachusetts General Hospital. Oncologist. 2016;21(9):1035-40. doi: 10.1634/theoncologist.2016-0240. PubMed PMID: 27551012; PubMed Central PMCID: PMCPMC5016066.
10. Larsen PO, von Ins M. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index. Scientometrics. 2010;84(3):575-603. doi: 10.1007/s11192-010-0202-z. PubMed PMID: 20700371; PubMed Central PMCID: PMCPMC2909426.
11. Mullard A. 2017 FDA drug approvals. Nat Rev Drug Discov. 2018;17(2):150. doi: 10.1038/nrd.2018.18. PubMed PMID: 29386602.
12. Wright AA, Katz IT. Beyond Burnout - Redesigning Care to Restore Meaning and Sanity for Physicians. N Engl J Med. 2018;378(4):309-11. doi: 10.1056/NEJMp1716845. PubMed PMID: 29365301.
13. Dzau VJ, Kirch DG, Nasca TJ. To Care Is Human - Collectively Confronting the Clinician-Burnout Crisis. N Engl J Med. 2018;378(4):312-4. doi: 10.1056/NEJMp1715127. PubMed PMID: 29365296.
14. Karsh BT, Weinger MB, Abbott PA, Wears RL. Health information technology: fallacies and sober realities. J Am Med Inform Assoc. 2010;17(6):617-23. doi: 10.1136/jamia.2010.005637. PubMed PMID: 20962121; PubMed Central PMCID: PMCPMC3000760.
15. Hesse BW, Ahern D, Beckjord E. Oncology informatics: Using health information technology to improve processes and outcomes in cancer: Academic Press; 2016.
16. Smith R. The trouble with medical journals. Journal of the Royal Society of Medicine. 2006;99(3):115-9.
17. Spasic I, Livsey J, Keane JA, Nenadic G. Text mining of cancer-related information: review of current status and future directions. Int J Med Inform. 2014;83(9):605-23. doi: 10.1016/j.ijmedinf.2014.06.009. PubMed PMID: 25008281.
18. Winn RJ. Oncology practice guidelines: do they work? Journal of the National Comprehensive Cancer Network. 2004;2(4):276-82.
19. Somerfield MR, Einhaus K, Hagerty KL, Brouwers MC, Seidenfeld J, Lyman GH. American Society of Clinical Oncology clinical practice guidelines: opportunities and challenges. Journal of Clinical Oncology. 2008;26(24):4022-6.
20. Kung J, Miller RR, Mackowiak PA. Failure of clinical practice guidelines to meet institute of medicine standards: two more decades of little, if any, progress. Archives of internal medicine. 2012;172(21):1628-33.
21. Balas EA, Puryear J, Mitchell JA, Barter B. How to structure clinical practice guidelines for continuous quality improvement? J Med Syst. 1994;18(5):289-97. PubMed PMID: 7861105.
22. Shahar Y, Miksch S, Johnson P. An intention-based language for representing clinical guidelines. Proc AMIA Annu Fall Symp. 1996:592-6. PubMed PMID: 8947735; PubMed Central PMCID: PMCPMC2233124.
23. Shahar Y, Shalom E, Mayaffit A, Young O, Galperin M, Martins S, et al., editors. A distributed, collaborative, structuring model for a clinical-guideline digital-library. AMIA Annual Symposium Proceedings; 2003: American Medical Informatics Association.
24. Shahar Y, Young O, Shalom E, Mayaffit A, Moskovitch R, Hessing A, et al. The Digital electronic Guideline Library (DeGeL): a hybrid framework for representation and use of clinical guidelines. Stud Health Technol Inform. 2004;101:147-51. PubMed PMID: 15537218.
25. Johnson PD, Tu S, Booth N, Sugden B, Purves IN. Using scenarios in chronic disease management guidelines for primary care. Proc AMIA Symp. 2000:389-93. PubMed PMID: 11079911; PubMed Central PMCID: PMCPMC2244127.
26. Tu SW, Musen MA. A flexible approach to guideline modeling. Proc AMIA Symp. 1999:420-4. PubMed PMID: 10566393; PubMed Central PMCID: PMCPMC2232509.
27. Peleg M, Boxwala AA, Ogunyemi O, Zeng Q, Tu S, Lacson R, et al. GLIF3: the evolution of a guideline representation format. Proc AMIA Symp. 2000:645-9. PubMed PMID: 11079963; PubMed Central PMCID: PMCPMC2243832.
28. Hripcsak G. Arden Syntax for Medical Logic Modules. MD Comput. 1991;8(2):76, 8. PubMed PMID: 2038238.
29. Kuhn RA, Reider RS. A C++ framework for developing Medical Logic Modules and an Arden Syntax compiler. Comput Biol Med. 1994;24(5):365-70. PubMed PMID: 7705067.
30. Jenders RA, Dasgupta B. Assessment of a knowledge-acquisition tool for writing Medical Logic Modules in the Arden Syntax. Proc AMIA Annu Fall Symp. 1996:567-71. PubMed PMID: 8947730; PubMed Central PMCID: PMCPMC2233222.
31. Choi J, Bakken S, Lussier YA, Mendonca EA. Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programmingexpressions. Comput Inform Nurs. 2006;24(4):220-5. PubMed PMID: 16849918; PubMed Central PMCID: PMCPMC2883181.
Published
2018-12-15
How to Cite
Cihoric, N., Igrutinovic, I., Tsikkinis, A., Vlaskou Badra, E., & Mackeprang, P.-H. (2018). A Step Forward in Cancer Informatics—It Is Mandatory to Make Guidelines Machine Readable. Journal of Radiation Oncology Informatics, 9(1). https://doi.org/10.5166/jroi-9-1-1
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