HIS-based Kaplan-Meier plots--a single source approach for documenting and reusing routine survival information

Area of Science:

• Medical Informatics
• Oncology
• Biostatistics

Background:

• Survival and outcome data are crucial for clinical practice and research.
• Current hospital information systems (HIS) lack support for comprehensive survival documentation, leading to paper-based or spreadsheet methods and data redundancy.
• This necessitates an investigation into integrating follow-up documentation within the HIS for efficient survival analysis.

Purpose of the Study:

• To investigate the feasibility of integrating survival documentation into the HIS for timely survival curve generation.
• To avoid redundant data collection by reusing information within the HIS.
• To enable physicians to obtain survival curves efficiently for clinical routine and research.

Main Methods:

• Analyzed current oncological patient follow-up processes in urology and hematology departments.
• Developed a generic data model and implemented an electronic follow-up form within the HIS at University Hospital Muenster.
• Designed data extraction queries and implemented Kaplan-Meier plots, assessing data completeness for survival analysis.

Main Results:

• Identified 52 attributes, with 13 common to both departments, forming the basis of the generic data model.
• Integrated electronic follow-up forms into clinical workflow, enabling retrospective data entry and timely Kaplan-Meier plot generation.
• Analyzed 1029 follow-up forms (965 patients, 1992-2010); form completeness was 60.2%, item completeness 94.3%-98.5%. Median overall survival: 16.4 years; event-free survival: 7.7 years.

Conclusions:

• Integrating survival information into routine HIS documentation is feasible.
• Kaplan-Meier plots can be generated directly and in a timely manner from integrated HIS data.
• This approach enhances efficiency and data quality for survival analysis in clinical settings.