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

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

  • Affiliations:
  • -;-;-;-;-;-;-;-;-;-;-

  • Venue:
  • Computer Methods and Programs in Biomedicine
  • Year:
  • 2013

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Abstract

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 - BMI23.7 - 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.