Patient Care and Research

Minimum Data Element

The American Society for Radiation Oncology (ASTRO) has determined that defining a minimum set of data elements for radiation therapy is high priority activity. There is a deep and wide interest in leveraging Big Data in the oncology space as shown through the recent New York Times article,New Cancer Treatments Lie Hidden Under Mountains of Paperwork. Identifying a standard set of data elements is an important step in promoting Big Data initiatives.

ASTRO has also received requests for data elements from other societies, database architects, electronic health record (EHR) vendors and the pharmaceutical industry. These requests point to an increasing and shared interest in capturing radiation oncology data within registries, quality measurement, interoperability initiatives and clinical trials. In addition to these technical priorities, this effort can improve overall clinical care for cancer patients by increasing the visibility of radiation oncology treatment in other systems and reducing the time required for data entry by practice staff.

A review of radiation oncology data elements currently in use within national databases, ASTRO programs and resources from other cancer-related societies was conducted to identify possible overlap and priority. This analysis generated a short list of data elements to facilitate the myriad of use cases as well as define the minimum radiation oncology relevant data that should be included in all scenarios. This document seeks to serve as a placeholder as we work to further explain and define the minimum necessary radiation oncology data elements. Promoting this list provides an opportunity to educate those outside of the field about what data is necessary to capture and transfer.

Minimum Data Elements

Data Element Definition Detail
Treatment Course Data Elements
Diagnosis Identify disease(s) relevant to treatment ICD-10
Modality Radiation type - Records the list of all modalities used during treatment course (Check all that apply) List provided
Technique Treatment delivery method - Records the list of all techniques used during treatment course (Check all that apply) List provided
Number of fractions planned Records the total number of treatments prescribed in a treatment  
Number of fractions delivered Records the total number of treatments delivered in a treatment course  
Start date of treatment Indicates the date on which the patient commences course of delivered radiation treatment MMDDYYYY
End date of treatment Indicates the date on which the patient ends/completes a course of delivered radiation treatment MMDDYYYY
Prescribed Dose Level Data Elements
Anatomic site of each prescribed dose level Indicates the primary anatomic site(s) targets for each dose level Reference the Standards for Oncology Registry Entry
Total dose planned for each prescribed dose level Dose prescribed to each dose level cGy
Total dose delivered for each prescribed dose level Dose delivered to each dose level cGy
 

ASTRO believes the promotion of these minimum data elements will support many of the organization’s objectives as follows:

  • Research. Currently, many clinical trial datasets merely document administration of radiation therapy as a checkbox. This proposed list provides consistency and clarity in research efforts that can expand the quantity and quality of radiation data in clinical trials. Defining such minimum data elements can also promote the incorporation of radiation oncology into clinical trials and encourage inclusion of radiation oncology earlier in clinical trial timelines.
     
  • Quality. Sharing information across systems, with common definitions, can provide a reduction of duplicated procedures which can be costly and impinge on a patient’s care experience. The common list can safeguard that data has same definition when transferred out of an oncology information system into a more generalized EHR.
     
  • Informatics. A list of data elements allows radiation oncology to have a standard presence in informatics development as the Centers for Medicare and Medicaid Services (CMS) shifts towards interoperability, and patient-data access, within value-based care models.

ASTRO acknowledges that there are additional cross-specialty data elements integral to oncology that need specification. ASTRO is interested in collaborating on these elements with other oncology leaders to create unified definitions for all oncology specialties.

  • Course Number/ID
  • Treatment Intent
  • Treatment Breaks
  • Current Disease Status
  • Off Target/Out-of-Field Response
  • Staging (TMN when applicable)

A consensus group is working to develop a paper providing more detail about the information that is expected to be contained in each of these data elements. 

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