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Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director, Pathology Informatics Cancer Diagnosis Program, NCI, NIH email: [email protected]

Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

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Page 1: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Pathology data sharing

United States Military Cancer InstituteWalter Reed Army Medical CenterNovember 16, 2004

Jules J. Berman, Ph.D., M.D.Program Director, Pathology InformaticsCancer Diagnosis Program, NCI, NIHemail: [email protected]

Page 2: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

UFO Abductees

Lots of them

They often say about the same thing (independent confirmations)

All walks of life

Minority are a little crazy

Mostly honest and rational people

One problem: no evidence

Page 3: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Researchers who don’t publish their primary data

Lots of them

They often say about the same thing (independent confirmations)

All walks of life

Minority are a little crazy

Mostly honest and rational people

One problem: no evidence

Page 4: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

After your research data reaches a certain size, the data becomes the publication, and the journal articles become tiny editorials that describe or interpret the data

Page 5: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

In a data-intensive world, the data is the center of the universe. Manuscripts are satellites revolving around a central large BLOB of data.

Page 6: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Sticks and carrots:

NIH Statement on Data Sharinghttp://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-032.html

National Research Council UPSIDE Universal Principle of Sharing Integral Data Expeditiouslyhttp://books.nap.edu/books/0309088593/html/R1.html

Page 7: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

NIH Funding for data sharing

Shared Pathology Informatics Networkhttp://grants.nih.gov/grants/guide/rfa-files/RFA-CA-01-006.html

Tools for collaborations that involve data sharinghttp://grants1.nih.gov/grants/guide/pa-files/PAR-03-134.html

Infrastructure for data sharing and archivinghttp://grants.nih.gov/grants/guide/rfa-files/RFA-HD-03-032.html

caBIGhttp://cabig.nci.nih.gov/

Page 8: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Confidentiality methods

Page 9: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Two U.S. regulations that tell us how we can use medical records in research:

Common Rule & HIPAA Privacy Rule

In pathology informatics, the most ambitious research typically involves hundreds of thousands or millions of patient records. Getting informed consent for these studies is not feasible.

HIPAA and Common Rule both work under the principle that medical research is good, and it can be conducted without getting patient consent if you can come up with a way to avoid harming patients (no harm, no consent for harm).

Page 10: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

hipaa

Page 11: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

IRB

Page 12: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Corporate Lawyer

Page 13: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Irate Human Subject

Page 14: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Principle Investigator

Page 15: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Articles:

Berman JJ. Confidentiality for Medical Data Miners. Artificial Intelligence in Medicine. 26(1-2):25-36, 2002.

Berman JJ. Concept-Match Medical Data Scrubbing: How pathology datasets can be used in research. Arch Pathol Lab Med. 2003 Jun;127(6):680-6.

Berman JJ. Threshold protocol for the exchange of confidential medical data. BMC Medical Research Methodology, 2002, 2:12.

Page 16: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

More:

Berman JJ. A tool for sharing annotated research data: the "Category 0" UMLS (Unified Medical Language System) vocabularies. BMC Med Inform Decis Mak. 2003 Jun 16;3(1):6.

Berman JJ. Zero-check: a zero-knowledge protocol for reconciling patient identities across institutions.Arch Pathol Lab Med. 2004 Mar;128(3):344-6.

Berman JJ. Racing to share pathology data. Am J Clin Pathol. 2004 Feb;121(2):169-71 (editorial).

Page 17: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Standard ways of organizing data (nomenclatures, taxonomies, classifications, data structures)

Page 18: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Director’s Challenge: Toward a molecular classification of tumors

In January 1999, the U.S. National Cancer Institute (NCI) issued a challenge to the scientific community "to harness the power of comprehensive molecular analysis technologies to make the classification of tumors vastly more informative. This challenge is intended to lay the groundwork for changing the basis of tumor classification from morphological to molecular characteristics."

Page 19: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Impediment: Misunderstanding about the definition of classification

Page 20: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Classifications are not:

Identification systems

Taxonomies and nomenclatures

Ontologies

Achieved by analyzing gene expression array data

Page 21: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

What is a [tumor] classification?

A grouped taxonomy [listing of all tumors] with the following properties:

Inheritance: Hierarchical structure, with each class of tumors inheriting properties of its ancestors

Uniqueness: Each tumor occurs in only one place in the classification

Comprehensive: All tumors are included

Intransitive: A tumor from one class does not change into a tumor from another class (e.g. an adenocarcinoma does not become a lymphoma)

Page 22: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Problems with current tumor classifications

1. Created piecemeal

2. Often based on medical disciplines

3. A given tumor can appear redundantly when subclassifications are merged

4. No tumor classification has been prepared in a standard format designed to exchange, merge or analyze heterogeneous biological data

Page 23: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

New Tumor Classification

Comprehensive ~122,000 terms (9 Megabytes)

Based on developmental and molecular biologic features of tumors

Heritable class structure with a unique class location for each tumor

XML document that can be cross-annotated with molecular biology databases

Preserves current tumor names, while abandoning purely morphologic categories (e.g. epithelial/stromal)

Page 24: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Latest version of the nomenclature:

http://www.pathologyinformatics.org/informatics_r.htm

122,000+ terms

Copy of paper:Berman JJ. Tumor classification: molecular analysis meets Aristotle. BMC Cancer 2004 4:10, 17 March 2004http://www.biomedcentral.com/1471-2407/4/10

Page 25: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Standard ways of exchanging data

Page 26: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

XML is the greatest information organizing tool since the invention of the book.

Much more important than HTML

Takes advantage of:

Metadata

Namespaces

Internet

External links

Page 27: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Example: Tissue Microarray Data Exchange Specification

The TMA Specification is an open access document that can be used without any restriction.

Its development was sponsored by the NCI and by the Association for Pathology Informatics

Page 28: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,
Page 29: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

Basics of the specification:

Jules J Berman, Mary Edgerton and Bruce Friedman. The tissue microarray data exchange specification: a community-based, open source tool for sharing tissue microarray data. BMC Med Inform Decis Mak. 2003 May 23;3:5

Real-world implementation example:

Jules J Berman, Milton Datta, Andre Kajdacsy-Balla, Jonathan Melamed, Jan Orenstein, Kevin Dobbin, Ashok Patel, Rajiv Dhir, Michael J Becich. The tissue microarray data exchange specification: implementation by the Cooperative Prostate Cancer Tissue Resource. BMC Bioinformatics 2004 Feb 27, 5:19

Page 30: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

LDIP (Laboratory Digital Imaging Project)

Association for Pathology Informatics

Pathology Image Data Exchange Specification

Information available at:

http://www.pathologyinformatics.org/ldip.htm

Page 31: Pathology data sharing United States Military Cancer Institute Walter Reed Army Medical Center November 16, 2004 Jules J. Berman, Ph.D., M.D. Program Director,

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