A semantic interoperability approach to support integration of gene expression and clinical data in breast cancer

INTRODUCTION The introduction of omics data and advances in technologies involved in clinical treatment has led to a broad range of approaches to represent clinical information. Within this context, patient stratification across health institutions due to omic profiling presents a complex scenario to carry out multi-center clinical trials. METHODS This paper presents a standards-based approach to ensure semantic integration required to facilitate the analysis of clinico-genomic clinical trials. To ensure interoperability across different institutions, we have developed a Semantic Interoperability Layer (SIL) to facilitate homogeneous access to clinical and genetic information, based on different well-established biomedical standards and following International Health (IHE) recommendations. RESULTS The SIL has shown suitability for integrating biomedical knowledge and technologies to match the latest clinical advances in healthcare and the use of genomic information. This genomic data integration in the SIL has been tested with a diagnostic classifier tool that takes advantage of harmonized multi-center clinico-genomic data for training statistical predictive models. CONCLUSIONS The SIL has been adopted in national and international research initiatives, such as the EURECA-EU research project and the CIMED collaborative Spanish project, where the proposed solution has been applied and evaluated by clinical experts focused on clinico-genomic studies.

[1]  P. Trott,et al.  International Classification of Diseases for Oncology , 1977 .

[2]  Sherri de Coronado,et al.  NCI Thesaurus: A semantic model integrating cancer-related clinical and molecular information , 2007, J. Biomed. Informatics.

[3]  Gene Ontology Consortium The Gene Ontology (GO) database and informatics resource , 2003 .

[4]  Anca I. D. Bucur,et al.  Semantic Normalization and Query Abstraction Based on SNOMED-CT and HL7: Supporting Multicentric Clinical Trials , 2015, IEEE Journal of Biomedical and Health Informatics.

[5]  Gil Alterovitz,et al.  SMART on FHIR Genomics: facilitating standardized clinico-genomic apps , 2015, J. Am. Medical Informatics Assoc..

[6]  Rachel L Richesson,et al.  Viewpoint: Data Standards in Clinical Research: Gaps, Overlaps, Challenges and Future Directions , 2007, J. Am. Medical Informatics Assoc..

[7]  Patrice Degoulet,et al.  Translational research platforms integrating clinical and omics data: a review of publicly available solutions , 2014, Briefings Bioinform..

[8]  C. McDonald,et al.  LOINC, a universal standard for identifying laboratory observations: a 5-year update. , 2003, Clinical chemistry.

[9]  Mathew W. Wright,et al.  The HUGO Gene Nomenclature Committee (HGNC) , 2001, Human Genetics.

[10]  M. Levy,et al.  Integrating cancer genomic data into electronic health records , 2016, Genome Medicine.

[11]  Richard Platt,et al.  Launching PCORnet, a national patient-centered clinical research network , 2014, Journal of the American Medical Informatics Association : JAMIA.

[12]  Tim Benson,et al.  Principles of Health Interoperability HL7 and SNOMED , 2009 .

[13]  Victor Maojo,et al.  A Data Model Based on Semantically Enhanced HL7 RIM for Sharing Patient Data of Breast Cancer Clinical Trials , 2013, MedInfo.

[14]  Henry Lieberman,et al.  Sesame: An Architecture for Storing and Querying RDF Data and Schema Information , 2005 .

[16]  Jill P. Mesirov,et al.  Criteria for the use of omics-based predictors in clinical trials , 2013, Nature.

[17]  Antonio Bernardini,et al.  IHE: integrating the healthcare enterprise, towards complete integration of healthcare information systems. , 2003, Rays.

[18]  Christian Gieger,et al.  Harmonising and linking biomedical and clinical data across disparate data archives to enable integrative cross-biobank research , 2015, European Journal of Human Genetics.

[19]  E. Perakslis,et al.  Effective knowledge management in translational medicine , 2010, Journal of Translational Medicine.

[20]  Anca I. D. Bucur,et al.  Analysis of the Suitability of Existing Medical Ontologies for Building a Scalable Semantic Interoperability Solution Supporting Multi-site Collaboration in Oncology , 2014, 2014 IEEE International Conference on Bioinformatics and Bioengineering.

[21]  Griffin M. Weber,et al.  Serving the enterprise and beyond with informatics for integrating biology and the bedside (i2b2) , 2010, J. Am. Medical Informatics Assoc..

[22]  J. Overhage,et al.  Advancing the Science for Active Surveillance: Rationale and Design for the Observational Medical Outcomes Partnership , 2010, Annals of Internal Medicine.

[23]  Kent A. Spackman,et al.  Normal forms for description logic expressions of clinical concepts in SNOMED RT , 2001, AMIA.

[24]  B Marshall,et al.  Gene Ontology Consortium: The Gene Ontology (GO) database and informatics resource , 2004, Nucleic Acids Res..

[25]  Freddy Priyatna,et al.  R2RML-based Access and Querying to Relational Clinical Data with Morph-RDB , 2015, SWAT4LS.

[26]  Matthew D. Wilkerson,et al.  ConsensusClusterPlus: a class discovery tool with confidence assessments and item tracking , 2010, Bioinform..

[27]  P. Cochat,et al.  Et al , 2008, Archives de pediatrie : organe officiel de la Societe francaise de pediatrie.

[28]  O Bodenreider,et al.  Biomedical ontologies in action: role in knowledge management, data integration and decision support. , 2008, Yearbook of medical informatics.

[29]  Carme Camps,et al.  microRNA-associated progression pathways and potential therapeutic targets identified by integrated mRNA and microRNA expression profiling in breast cancer. , 2011, Cancer research.

[30]  C. Muir,et al.  International Classification of Diseases for Oncology , 1990 .

[31]  Yike Guo,et al.  tranSMART: An Open Source and Community-Driven Informatics and Data Sharing Platform for Clinical and Translational Research , 2013, AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science.

[32]  Frank van Harmelen,et al.  Sesame: An Architecture for Storin gand Querying RDF Data and Schema Information , 2003, Spinning the Semantic Web.

[33]  Abel N. Kho,et al.  Practical challenges in integrating genomic data into the electronic health record , 2013, Genetics in Medicine.

[34]  Antoni Castells,et al.  The Long-term Results of a Randomized Clinical Trial of Laparoscopy-assisted Versus Open Surgery for Colon Cancer , 2008, Annals of surgery.

[35]  実 細羽 9.医療情報システムの相互運用性(4) IHE(integrating the healthcare enterprise) , 2007 .

[36]  Cary P Gross,et al.  The importance of clinical trial data sharing: toward more open science. , 2012, Circulation. Cardiovascular quality and outcomes.

[37]  Patrick McConnell,et al.  The cancer translational research informatics platform , 2008, BMC Medical Informatics Decis. Mak..

[38]  G W Beeler,et al.  HL7 version 3--an object-oriented methodology for collaborative standards development. , 1998, International journal of medical informatics.

[39]  Kamran Sartipi,et al.  HL7 FHIR: An Agile and RESTful approach to healthcare information exchange , 2013, Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.

[40]  Kevin Donnelly,et al.  SNOMED-CT: The advanced terminology and coding system for eHealth. , 2006, Studies in health technology and informatics.