Current applications and future directions for the CDISC Operational Data Model standard: A methodological review

INTRODUCTION In order to further advance research and development on the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) standard, the existing research must be well understood. This paper presents a methodological review of the ODM literature. Specifically, it develops a classification schema to categorize the ODM literature according to how the standard has been applied within the clinical research data lifecycle. This paper suggests areas for future research and development that address ODM's limitations and capitalize on its strengths to support new trends in clinical research informatics. METHODS A systematic scan of the following databases was performed: (1) ABI/Inform, (2) ACM Digital, (3) AIS eLibrary, (4) Europe Central PubMed, (5) Google Scholar, (5) IEEE Xplore, (7) PubMed, and (8) ScienceDirect. A Web of Science citation analysis was also performed. The search term used on all databases was "CDISC ODM." The two primary inclusion criteria were: (1) the research must examine the use of ODM as an information system solution component, or (2) the research must critically evaluate ODM against a stated solution usage scenario. Out of 2686 articles identified, 266 were included in a title level review, resulting in 183 articles. An abstract review followed, resulting in 121 remaining articles; and after a full text scan 69 articles met the inclusion criteria. RESULTS As the demand for interoperability has increased, ODM has shown remarkable flexibility and has been extended to cover a broad range of data and metadata requirements that reach well beyond ODM's original use cases. This flexibility has yielded research literature that covers a diverse array of topic areas. A classification schema reflecting the use of ODM within the clinical research data lifecycle was created to provide a categorized and consolidated view of the ODM literature. The elements of the framework include: (1) EDC (Electronic Data Capture) and EHR (Electronic Health Record) infrastructure; (2) planning; (3) data collection; (4) data tabulations and analysis; and (5) study archival. The analysis reviews the strengths and limitations of ODM as a solution component within each section of the classification schema. This paper also identifies opportunities for future ODM research and development, including improved mechanisms for semantic alignment with external terminologies, better representation of the CDISC standards used end-to-end across the clinical research data lifecycle, improved support for real-time data exchange, the use of EHRs for research, and the inclusion of a complete study design. CONCLUSIONS ODM is being used in ways not originally anticipated, and covers a diverse array of use cases across the clinical research data lifecycle. ODM has been used as much as a study metadata standard as it has for data exchange. A significant portion of the literature addresses integrating EHR and clinical research data. The simplicity and readability of ODM has likely contributed to its success and broad implementation as a data and metadata standard. Keeping the core ODM model focused on the most fundamental use cases, while using extensions to handle edge cases, has kept the standard easy for developers to learn and use.

[1]  Kevin Burges Discover Define-XML , 2014 .

[2]  Julie Evans,et al.  Model Formulation: The BRIDG Project: A Technical Report , 2008, J. Am. Medical Informatics Assoc..

[3]  Christel Daniel-Le Bozec,et al.  Integrating clinical research with the Healthcare Enterprise: From the RE-USE project to the EHR4CR platform , 2011, J. Biomed. Informatics.

[4]  Diego Boscá,et al.  Interoperability of clinical decision-support systems and electronic health records using archetypes: A case study in clinical trial eligibility , 2013, J. Biomed. Informatics.

[5]  C Ohmann,et al.  Future Developments of Medical Informatics from the Viewpoint of Networked Clinical Research , 2009, Methods of Information in Medicine.

[6]  Gottfried Vossen,et al.  Exploiting XML Technologies in Medical Information Systems , 2012, Bled eConference.

[7]  Mark Wheeldon,et al.  PharmaSUG 2014 - Paper DS01 Discover Define-XML , 2014 .

[8]  Cédric Bousquet,et al.  Aligning HL7 CDA Templates and CDISC ODM: An Experiment in Cardiovascular Radiology , 2007 .

[9]  Laurent Lefort,et al.  Design and generation of Linked Clinical Data Cubes , 2013, SemStats@ISWC.

[10]  Klaus Kabino,et al.  Integrating image management and analysis into OpenClinica using web services , 2013, Medical Imaging.

[11]  Jeremy Iverson,et al.  Comprehensive Citation Across the Data Life Cycle Using DDI , 2014 .

[12]  Tao Chen,et al.  Clinical Data Management System , 2010, 2010 International Conference on Biomedical Engineering and Computer Science.

[13]  Ling Li Fu,et al.  Web-Based Case Report Form Design for Clinical Trial , 2010 .

[14]  Stephen J. Ruberg,et al.  Toward a Comprehensive CDISC Submission Data Standard , 2007 .

[15]  Martin Dugas,et al.  Semantic enrichment of medical forms - semi-automated coding of ODM-elements via web services. , 2012, Studies in health technology and informatics.

[16]  Christel Daniel-Le Bozec,et al.  Using electronic health records for clinical research: The case of the EHR4CR project , 2015, J. Biomed. Informatics.

[17]  Keiji Tamaki,et al.  Legal Medicine Information System using CDISC ODM. , 2013, Legal medicine.

[18]  James J. Cimino,et al.  Standardizing data exchange for clinical research protocols and case report forms: An assessment of the suitability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) , 2015, J. Biomed. Informatics.

[19]  Prakash M. Nadkarni,et al.  Data standards for clinical research data collection forms: current status and challenges , 2011, J. Am. Medical Informatics Assoc..

[20]  Jürgen Stausberg,et al.  The ISO/IEC 11179 norm for metadata registries: Does it cover healthcare standards in empirical research? , 2013, J. Biomed. Informatics.

[21]  Martin Dugas,et al.  Integrated Data Management for Clinical Studies: Automatic Transformation of Data Models with Semantic Annotations for Principal Investigators, Data Managers and Statisticians , 2014, PloS one.

[22]  Stephen B. Soumerai,et al.  Fostering Responsible Data Sharing through Standards , 2014 .

[23]  Gunnar Declerck,et al.  Building the Semantic Interoperability Architecture Enabling Sustainable Proactive Post Market Safety Studies * , 2012 .

[24]  Philipp Bruland,et al.  Transformations between CDISC ODM and openEHR Archetypes , 2014, MIE.

[25]  Benjamin Trinczek,et al.  Multilingual Medical Data Models in ODM Format , 2012, Applied Clinical Informatics.

[26]  Nikolay S. Nepochatov Translational research web application framework , 2009 .

[27]  Wolfgang Kuchinke,et al.  CDISC Standard-based Electronic Archiving of Clinical Trials , 2009, Methods of Information in Medicine.

[28]  Laurent Lefort,et al.  A method for the semantic enrichment of clinical trial data , 2012, HIC.

[29]  Jim Davies,et al.  Metadata-driven software for clinical trials , 2009, 2009 ICSE Workshop on Software Engineering in Health Care.

[30]  Hyeokman Kim,et al.  Language Supports for Multinational Clinical Trials in CDISC Platform , 2013 .

[31]  Andrew Newbigging Using web service technologies for incremental, real-time data transfers from EDC to SAS , 2010 .

[32]  Fleur Fritz,et al.  Interoperability in clinical research: from metadata registries to semantically annotated CDISC ODM. , 2012, Studies in health technology and informatics.

[33]  Fleur Fritz,et al.  HIS-based Kaplan-Meier plots - a single source approach for documenting and reusing routine survival information , 2011, BMC Medical Informatics Decis. Mak..

[34]  Athanasios Anastasiou,et al.  Data modeling methods in clinical trials: experiences from the clinical trial methods in neurodegenerative diseases project , 2011, Trials.

[35]  Laurent Lefort,et al.  Using CDISC ODM and the RDF Data Cube for the Semantic Enrichment of Longitudinal Clinical Trial Data , 2012, SWAT4LS.

[36]  Peter Van Reusel Clinical Data Interchange Standards Consortium (CDISC) integration into the Oracle Clinical/Remote Data Capture® (OC/RDC) clinical data management system , 2010 .

[37]  Jim Davies,et al.  Models for forms , 2011, SPLASH Workshops.

[38]  Michael Weber,et al.  Generating User Interfaces from CDISC ODM for Mobile Devices , 2006, 2006 International Conference on Mobile Business.

[39]  Vasa Curcin,et al.  Standard-based integration profiles for clinical research and patient safety , 2013, AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science.

[40]  Fleur Fritz,et al.  Automated UMLS-Based Comparison of Medical Forms , 2013, PloS one.

[41]  C Ohmann,et al.  Extended Cooperation in Clinical Studies through Exchange of CDISC Metadata between Different Study Software Solutions , 2006, Methods of Information in Medicine.

[42]  R. Kush,et al.  Global clinical data interchange standards are here! , 2007, Drug discovery today.

[43]  Eberhart Zrenner,et al.  Ophthabase: a generic extensible patient registry system , 2008 .

[44]  Fleur Fritz,et al.  Does single-source create an added value? Evaluating the impact of introducing x4T into the clinical routine on workflow modifications, data quality and cost-benefit , 2014, Int. J. Medical Informatics.

[45]  Christel Daniel-Le Bozec,et al.  The REUSE project: EHR as single datasource for biomedical research , 2010, MedInfo.

[46]  Pnina Vortman,et al.  Revolutionary impact of XML on biomedical information interoperability , 2006, IBM Syst. J..

[47]  Evelyn J. S. Hovenga,et al.  Can openEHR Archetypes Empower Multi-Centre Clinical Research? , 2005, MIE.

[48]  Julie Maddox Round Trip Ticket - Using the Define.xml file to Send and Receive your Study Specifications , 2013 .

[49]  D. Blumenthal Launching HITECH. , 2010, The New England journal of medicine.

[50]  Robert L. Martino,et al.  Performance of using Oracle XMLDB in the evaluation of CDISC ODM for a clinical study informatics system , 2004 .

[51]  Christopher G. Chute,et al.  A Collaborative Framework for Representation and Harmonization of Clinical Study Data Elements Using Semantic MediaWiki , 2010, Summit on translational bioinformatics.

[52]  Michael Lawley,et al.  ODM on FHIR: Towards Achieving Semantic Interoperability of Clinical Study Data , 2015, SWAT4LS.

[53]  Martin Dugas,et al.  The need for harmonized structured documentation and chances of secondary use - Results of a systematic analysis with automated form comparison for prostate and breast cancer , 2014, J. Biomed. Informatics.

[54]  Philipp Bruland,et al.  x4T-EDC: A Prototype for Study Documentation Based on the Single Source Concept , 2012 .

[55]  Rebecca Kush,et al.  A Standard Computable Clinical Trial Protocol: The Role of the BRIDG Model , 2007 .

[56]  Gottfried Vossen,et al.  The Single Source Architecture x4T to Connect Medical Documentation and Clinical Research , 2011, MIE.

[57]  Asuman Dogac,et al.  Providing Semantic Interoperability Between Clinical Care and Clinical Research Domains , 2013, IEEE Journal of Biomedical and Health Informatics.

[58]  Prakash M. Nadkarni,et al.  Leveraging a clinical research information system to assist biospecimen data and workflow management: a hybrid approach , 2011, Journal of Clinical Bioinformatics.

[59]  Alistair Dootson Tracing Data Elements through a Standard Data Flow , 2011 .

[60]  Jim Davies,et al.  The CancerGrid experience: Metadata-based model-driven engineering for clinical trials , 2014, Sci. Comput. Program..

[61]  Patrice Degoulet,et al.  Electronic Healthcare Record and Clinical Research in Cardiovascular Radiology. HL7 CDA and CDISC ODM Interoperability , 2007, AMIA.

[62]  Martin Dugas,et al.  Analyses of Medical Data Models - Identifying Common Concepts and Items in a Repository of Medical Forms , 2013, MedInfo.

[63]  Perry L. Miller,et al.  Metadata-driven creation of data marts from an EAV-modeled clinical research database , 2002, Int. J. Medical Informatics.

[64]  Daniel Haak,et al.  OC ToGo: bed site image integration into OpenClinica with mobile devices , 2014, Medical Imaging.

[65]  Robert L. Martino,et al.  Performance of using Oracle XMLDB in the evaluation of CDISC ODM for a clinical study informatics system , 2004, Proceedings. 17th IEEE Symposium on Computer-Based Medical Systems.

[66]  Eladio Domínguez,et al.  Model-Driven Development Based Transformation of Stereotyped Class Diagrams to XML Schemas in a Healthcare Context , 2007, ER Workshops.

[67]  T Ganslandt,et al.  Unlocking Data for Clinical Research – The German i2b2 Experience , 2011, Applied Clinical Informatics.