Tools for large-scale data analytics of an international multi-center study in radiation oncology for cervical cancer

Stefan Ecker*, Christian Kirisits, Maximilian Schmid, Astrid De Leeuw, Yvette Seppenwoolde, Johannes Knoth, Petra Trnkova, Gerd Heilemann, Alina Sturdza, Kathrin Kirchheiner, Sofia Spampinato, Monica Serban, Ina Jürgenliemk-Schulz, Supriya Chopra, Remi Nout, Kari Tanderup, Richard Pötter, Nicole Eder-Nesvacil

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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PURPOSE: To develop and implement a software that enables centers, treating patients with state-of-the-art radiation oncology, to compare their patient, treatment, and outcome data to a reference cohort, and to assess the quality of their treatment approach.

MATERIALS AND METHODS: A comprehensive data dashboard was designed, which al- lowed holistic assessment of institutional treatment approaches. The software was tested in the ongoing EMBRACE-II study for locally advanced cervical cancer. The tool created individualized dashboards and automatic analysis scripts, verified pro- tocol compliance and checked data for inconsistencies. Identified quality assurance (QA) events were analysed. A survey among users was conducted to assess usability.

RESULTS: The survey indicated favourable feedback to the prototype and highlighted its value for internal monitoring. Overall, 2302 QA events were identified (0.4% of all collected data). 54% were due to missing or incomplete data, and 46% originated from other causes. At least one QA event was found in 519/1001 (52%) of patients. QA events related to primary study endpoints were found in 16% of patients. Sta- tistical methods demonstrated good performance in detecting anomalies, with precisions ranging from 71% to 100%. Most frequent QA event categories were Treatment Technique (27%), Patient Characteristics (22%), Dose Reporting (17%), Outcome 156 (15%), Outliers (12%), and RT Structures (8%).

CONCLUSION: A software tool was developed and tested within a clinical trial in radia- tion oncology. It enabled the quantitative and qualitative comparison of institutional patient and treatment parameters with a large multi-center reference cohort. We demonstrated the value of using statistical methods to automatically detect implau- sible data points and highlighted common pitfalls and uncertainties in radiotherapy for cervical cancer.

Original languageEnglish
Article number109524
Number of pages10
JournalRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Publication statusPublished - May 2023


  • Data Science
  • Female
  • Humans
  • Quality Assurance, Health Care/methods
  • Radiation Oncology
  • Radiotherapy Planning, Computer-Assisted
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms/radiotherapy
  • Clinical trial monitoring
  • Data analytics
  • Cervical cancer


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