A sharable cloud-based pancreaticoduodenectomy collaborative database for physicians: Emphasis on security and clinical rule supporting

作者：Yu Hwan Jeu; Lai Hong Shiee; Chen Kuo Hsin; Chou Hsien Cheng; Wu Jin Ming^*; Dorjgochoo Sarangerel; Mendjargal Adilsaikhan; Altangerel Erdenebaatar; Tien Yu Wen; Hsueh Chih Wen; Lai Feipei

来源：Computer Methods and Programs in Biomedicine, 2013, 111(2): 488-497.

DOI：10.1016/j.cmpb.2013.04.019

• Clinical database
• Cloud
• Pancreaticoduodenectomy

Background: Pancreaticoduodenectomy (PD) is a major operation with high complication rate. Thereafter, patients may develop morbidity because of the complex reconstruction and loss of pancreatic parenchyma. A well-designed database is very important to address both the short-term and long-term outcomes after PD.
Objective: The objective of this research was to build an international PD database implemented with security and clinical rule supporting functions, which made the data-sharing easier and improve the accuracy of data.
Methods: The proposed system is a cloud-based application. To fulfill its requirements, the system comprises four subsystems: a data management subsystem, a clinical rule supporting subsystem, a short message notification subsystem, and an information security subsystem. After completing the surgery, the physicians input the data retrospectively, which are analyzed to study factors associated with post-PD common complications (delayed gastric emptying and pancreatic fistula) to validate the clinical value of this system.
Results: Currently, this database contains data from nearly 500 subjects. Five medical centers in Taiwan and two cancer centers in Mongolia are participating in this study. A data mining model of the decision tree analysis showed that elderly patients (>76 years) with pylorus-preserving PD (PPPD) have higher proportion of delayed gastric emptying. About the pancreatic fistula, the data mining model of the decision tree analysis revealed that cases with non-pancreaticogastrostomy (PG) reconstruction - body mass index (BMI) > 29.65 or PG reconstruction -BMI > 23.7 -non-classic PD have higher proportion of pancreatic fistula after PD.
Conclusions: The proposed system allows medical staff to collect and store clinical data in a cloud, sharing the data with other physicians in a secure manner to achieve collaboration in research.

• 出版日期2013-8