A CDE-based data structure for radiotherapeutic decision-making in breast cancer

The growing complexity of oncology and radiation therapy demands structured and precise data management strategies. The National Institutes of Health (NIH) have introduced Common Data Elements (CDEs) as a uniform approach to facilitate consistent data collection. However, there is currently a lack of a comprehensive set of CDEs for describing situations for and within radiation oncology. Specifically for breast cancer, where radiotherapeutic decision-making is complex and based on multiple diverse criteria, there is a clear need for more standardized data. Aim of this study was to create a CDE-based data structure for radiotherapeutic decision-making in breast cancer to promote structured data collection on the level of a local hospital.

Between May 2023 and May 2024, we conducted a case study at the radiation therapy department of a local hospital to develop a CDE-based data structure for radiotherapeutic decision-making in breast cancer. Local Standard Operating Procedures (SOPs) were analyzed to identify relevant decision-making criteria used in clinical practice. Corresponding CDEs were identified, and a structured data framework based on these CDEs was created. The framework was translated into machine-readable JavaScript Object Notation (JSON) format. Six clinical practice guidelines of the American Society for Radiation Oncology (ASTRO) were analyzed as full text to evaluate how many guideline recommendations and corresponding decision-making criteria could be represented using our framework.

We identified 31 decision-making criteria from local SOPs, formalized into 46 CDEs. A hierarchical structure within an object-oriented data framework was created and converted into JSON format. 94 recommendations with mentioning of decision-making criteria in 216 cases were identified across the six ASTRO guidelines. In 151 cases (70.0%) the mentioned criterion could be presented with the data framework.

The CDE-based data structure provides a standardized, machine-readable framework for documenting and exchanging radiotherapeutic decision-making data in breast cancer patients. While further refinement is needed for broader interoperability, this approach facilitates structured data collection, enhances IT integration and supports standardized communication across different stakeholders.