CTCAE is designed to integrate into information networks for safety data exchange, and is expected to have a significant impact in data management for AE data collection, analysis, and patient outcomes associated with cancer research and care. EVS played a central role in designing and managing this effort, working closely with CTEP, DCP, VCDE, the Vocabulary Knowledge Center, and many participants from the broader community. The revision was developed and deployed using various EVS tools including the BiomedGT Wiki, Protégé editing tools, LexEVS terminology server, NCI Term Browser, and the EVS ftp site .
This database, which predates caBIG®, provides curated information for animal models of human cancers. caMOD annotates information with NCIt terminology, and uses the LexEVS API directly to generate anatomy and diagnosis tree hierarchies. 400 concepts were added or updated for caMOD in the past six months.
ICR (Integrative Cancer Research) Nanotechnology Working Group
caNanoLab has a goal of semantic interoperability across centers performing nanoparticle characterization studies. caNanoLab is based on an information model representing nanoparticles and their physical and in vitro characterization.
EVS provides assistance in curating concept definitions with the community, making them available in NCIt; a glossary of these terms also is provided within the caNanoLab application. (Funding for additional development was recently lost, but caNanoLab continues to be used.) The Nanotechnology Working Group includes about 60 people representing approximately 40 agencies, universities and institutes, a few from Europe. caNanolab is heavily used, representing substantial use of EVS effort. It currently contains 886 samples, 72 sample sources, 3,329 characterizations, and 41 protocols, and identifies 1,073 publications. The caNanoLab homepage shows 141,668 visitors since June 3, 2010. (See also additional nanotechnology-related detail below.)
Georgetown uses LexEVS and other EVS resources for its cancer Bench-to-Bedside (caB2B) project and other activities. A local LexEVS installation, and NCI's production LexEVS servers, provide terminology support for this project. This is an example of how terminology services are being incorporated into other tools as primary components in support of translational medicine.
Washington University uses LexEVS and EVS terminology content in its clinical data warehouse project (CIDER). Washington University deployed LexEVS in 2008 as the terminology server for CIDER. The terminologies are used to code data and for information retrieval. This is an example of an academic medical center adopting NCI EVS technology to support research and clinical enterprise infrastructure.
Ohio State University Medical Center
Ohio State is using LexEVS, NCIt, and NCIm, notably for openMDR. Ohio State University launched openMDR (open metadata repository) in 2009, using local instances of LexEVS, BioPortal, and caDSR. This is an example of an academic research group adopting several open source components of NCI's EVS and semantic infrastructure, and integrating them to create a novel tool for metadata management.
University of Pittsburgh
Pittsburgh uses the NCI Thesaurus cancer, anatomy, and pathology findings terminologies for their research and informatics projects. The ODIE project is used by the University of Pittsburgh, University of California, San Diego, and Children's Hospital, Boston. This collaboration has resulted in the publication of two papers in peer-reviewed journals so far:
- Tobias J, Chilukuri R, Komatsoulis GA, Mohantry S, Sioutos N, et al: The CAP Cancer Protocols-A Case Study of caCORE Based Data Standards Implementation to Integrate with the Cancer Biomedical Informatics Grid. BMC Medical Informatics Decision Making, 20; 6:25, 2006.
- Liu K, Chapman WW, Savova G, Chute CG, Sioutos N, Crowley RS:Effectiveness of Lexico-syntactic Pattern Matching for Ontology Enrichment with Clinical Documents. Methods Inf Med. 2010: 8;49(6).
Human Studies Database (HSDB) Consortium
HSDB is using LexEVS as a core component of its collaborative, distributed, clinical research systems. The OCRe Terminology is served through an NCBO site, which uses LexEVS. This is an example of a consortium of institutions leveraging LexEVS terminology services at the core of a new workflow for the collection of human studies data.
Common Biorepository Model (CBM)
EVS has provided about 1,300 concepts for this model through support for caDSR. CBM is used in many domains including clinical trials management, ICR, in vivo imaging, and tissue banks and pathology tools.
National Library of Medicine (NLM)
WHO work on ICD-11 is also using NCI Thesaurus as an important source of cancer terminology and definitions.
Stanford/National Center for Biomedical Ontology (NCBO)
NCBO bases its BioPortal terminology services on LexEVS. NCIt is generally at or near the top of the NCBO ontology use chart (see section 2 3 above). NCBO and EVS maintain ongoing coordination and harmonization efforts through both caBIG® and other channels. For example, NCBO participates in the VCDE working group on Representing Terminology Metadata, which is adapting work begun by NCBO in this area for use by NCI and NCRI. NCBO also makes its terminologies available through caGrid.
NCBO built its NCBO BioPortal ontology services on top of LexEVS, supporting a very wide collection of ontologies that are actively used in biomedicine. This is an example of how two federally-funded groups are working together on the development of resources that will benefit the biomedical terminology community.
Open Biomedical Ontologies (OBO)
EVS has worked with the OBO Foundry group since around 2005 to develop shared principles for open ontologies. NCI Thesaurus is designated as an Application ontology, since it uses and references domain ontologies within the OBO Foundry group. EVS makes several of the OBO Foundry ontologies available through LexEVS for caBIG® use. (For more information, visit the OBO Foundry website http://www.obofoundry.org/ .)
The Taiwan Cancer Registry
The Taiwan Cancer Registry, a population-based cancer registry founded in 1979, uses NCI Thesaurus terminology. Hospitals with greater than 50-bed capacity that provide outpatient and hospitalized cancer care are recruited to participate in reporting all newly diagnosed malignant neoplasms to this registry.
Other Sample Case Studies
Nanotechnology, and more specifically nanomedicine, has become important in the development of reagents for cancer detection and treatment. NCI established Cancer Centers of Nanotechnology Excellence (CCNE) to support translational nanomedical research. The NCI CCNE office became a partner with CBIIT in 2006 to develop a data sharing platform called caNanoLab.
NCI Thesaurus (NCIt) has been supporting concept curation for development of caNanoLab since its inception. NCIt editors have worked with the developers and users of caNanoLab from the CCNEs and other academic institutions to define concepts for data curation and to expand the object model to include data submission for both characterizations of experimental nanomaterials and translational research studies. (See additional details above.)
caBIG® has also established a Nanotechnology Working Group as part of its Integrative Cancer Research Workspace (ICR Nano WG) with a mission to federate nanotechnology databases. One requirement of this group has been to develop data and vocabulary standards to facilitate federation and increase data accessibility. The EVS is contributing to this effort as active participants in the working group. Part of the working group effort is the continuing development of the Nanoparticle Ontology (NPO) from Washington University in St. Louis. EVS has supported this effort in several areas: giving feedback on ontology structure and terminology best practices, supporting NPO curation using the NCI Protégé platform, loading and hosting NPO on LexEVS, preparing NPO for integration into the NCI Metathesaurus (NCIm), and planning for future editing of NPO in the BiomedGT Wiki collaborative editing environment.
NPO (NanoParticle Ontology): This terminology is loaded in NCI Metathesaurus, on LexEVS, and on the NCI Term Browser. NPO curators use the NCI Protégé curation tool and they use NCI Thesaurus as a cross-reference and a source for some of their definitions.
NanoTAB: Developed by CBIIT, Oregon State University, PNNL, Washington University St. Louis, Stanford, Jackson Labs, Pennsylvania BioNano Systems, NIOSH, NCI Frederick NCL, Emory/Georgia Tech. This tool is used by all members of the ICR Nano Working Group. Despite recent loss of caNanoLab funding, NanoTAB continues to be used heavily.
Imaging standards development requires the support of multiple products made available through EVS, including publication of Radlex terminology, developed through a collaboration of the Radiological Society of North America (RSNA), which convened experts in imaging informatics and radiological subspecialties to create this resource, now made freely available. RadLex has developed into a rich, structured radiology-specific ontology, which currently includes more than 30,000 terms and to which EVS provides content as well as publication support. EVS incorporates RadLex into the NCI Metathesaurus, and also supports imaging terminology in the NCI Thesaurus as needed by the imaging community.
MedDRA (Medical Dictionary for Regulatory Activities) is an ICH standard for regulatory reporting. EVS contributes to updates of the cancer domain for this widely employed international terminology. The NCI Thesaurus is used as the basis to update MedDRA neoplastic terminology. MedDRA is translated into 11 languages, with approximately 3,000 institutional subscribers from 60 countries.
Use of LexEVS
MD Anderson is using a local LexEVS server as part of their enterprise infrastructure. Special resources were dedicated to resolving initial software compatibility and other issues, ensuring a successful deployment. NCI EVS terminology browsers have also been deployed, as have NCIt and other EVS terminology resources. This is an example of leveraging a wide range of EVS resources and services in support of the research and clinical enterprise infrastructure of a leading cancer center.
Emory University is using LexEVS to develop and host local ontologies. Uses include terminology support for an analytic data warehouse, which incorporates custom patient classes defined using ICD-9 codes. This is an example of an academic medical center deploying and extending EVS components.
GE is developing a platform called Qualibria, which includes LexEVS as a terminology server. VKC has been working with GE since 2008. As part of the collaboration, GE created an extension to the LexEVS 5.1 API based on the Common Terminology Services specification. GE provided the code for that extension, which is now available to the community via the VKC web site. This is an example of NCI open source technology being bundled into a commercial healthcare product.
Mayo Health Solutions Global Products and Solutions is in the process of deploying LexEVS for terminology hosting and management. The project will eventually migrate to the GE Qualibria platform, which also uses LexEVS. This is an example of industry partners engaged in the development and commercialization of NCI open source tooling.
The Biomedical Knowledge Engineering (BiKE) lab at Seoul National University, Korea, adopted the 2005 version of the LexGrid model and over the last several years created an entire terminology-based application suite on that model. The VKC is currently working with BiKE to finalize an agreement under which they would provide to us the source code for a terminology mapping UI that was developed as part of their project. This would be a potentially significant contribution, as it would add a new tool in an area with a known gap in the current functionality of LexEVS.
McGill University Health Center, Canada, is connected to the TRANSFoRm project for European health care reform. LexEVS was chosen as the terminology server for the project, but a new loader is required in support of the ATC terminology. The VKC is currently working with them on the development of the ATC loader, which includes requirements gathering, coding, testing, and documentation. This represents an example where a project-specific use case provided by a customer is used as the basis for collaborative development of an open source contribution.