Services are coordinated by the CIS Co-Directors, Drs. Becich and Chandran. and are described in the text that follows. The CIS facilitates quality controlled collection of clinical information via a variety of information systems managed by Dr. Becich and his team. These clinical information systems which feed data to the research information systems ofthe CIS include the Clinical Trials Management Application (CTMA), the Pathology Laboratory Systems (Corner's CoPath Plus for anatomic pathology and Misys'Flexilab for clinical pathology), the Immunologic Monitoring and Cellular Products Laboratories (IMCPL), the Registry Research Information Service (ImPath), and three electronic medical records systems [the Medical Archival System (MARS, Inc.), Corner's PowerChart and Epic's EpicCare System]. These seven clinical systems (with the exception of ImPath) all use HL7 (Health Level 7, see www.hl7.org/) messaging to pass data to (and in some instances from) our research information systems. The diagram below shows the information flow from our clinical systems to our honest brokers information systems (Cancer Registry &Tissue Banking Systems). The research data that is in highest demand in our current environment comes from four sources: 1) clinical trials, 2) clinical annotation of tissue and serum samples, 3) information management and analysis related to microarray (tissue and cDNA) and proteomic experiments, and 4) clinical abstracts of patient treatment and outcome for translational research. We have built CTMA to serve the complete needs of clinical trials at UPCI. This is a system that manages a clinical trial from protocol proposal to closing of the trial. The functional modules of CTMA are described in the sections that follow. Data from the anatomic pathology Laboratory Information Systems or LIS (CoPath Plus) is entered into Synoptic Templates (structured data entry forms) that were developed by the Pathology Department in collaboration with the surgeons, medical oncologists, and other key UPCI members. These cancer checklists are entered into pathology reports and stored in discrete data elements in the LIS. These data are then stored in our data warehouse and combined with data extracted from the ImPath Cancer Registry. The integrated Cancer Registry has a research information services group that focuses on collecting organ site specific data into the ImPath system from a variety of sources, including our two medical record systems, our Radiology Information Systems, our Radiation Therapy Information System, and chart review in medical oncologists'and surgeons'offices. The Registry Research Information Service (RIS) and the LIS units form the foundation of our Tissue Banking and Pathology Tools. Our tissue banking and pathology tools include the caBIG? program's caTIES and caTISSUE Suite and other systems that were developed for cancer researchers to gain access to de-identified clinical, pathology, and outcomes data to identify cohorts for study. The Oracle data warehouse that is the basis for all of our research applications can also be queried via Discovery Tools (Oracle) to do ad hoc queries to structure data in SPSS and other SQL transforms for use by biostatisticians, cancer researchers, and clinical outcomes researchers. We have a sophisticated set of output tools developed in Crystal Reports (Crystal Decisions;Vancouver, BC) to provide detailed reporting formats. We work collaboratively with the Clinical Research Services and the Biostatistics Facility to provide them with high quality reports and data output to facilitate cancer research.
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