E-prostate, an integrated e-health system for the multidisciplinary management of prostate cancer patients

Introduction & Objectives: Identify significant variables on prostate cancer diagnosis, treatment and follow up to developing an integrated e-health system for data capture, management and analysis. Material & Methods: In July 2005 the working team of our multidisciplinary clinic (Prostate Programme, National Cancer Institute, Milan - NCIM) began the analysis of significant variables in prostate cancer (PCa) management. The research team was composed of urologists, radiation oncologists, medical oncologists, palliative oncologists, psychologists, radiologists, pathologists, experimental researchers and a medical oncology skilled in information technology (IT). In this first phase, the team identified the essential variables to be considered for the e-Prostate project through the analysis of the state-of-art of PCa diagnosis/ treatment/follow up and of factors characterizing our institutional PCa guidelines.(http://www.istitutotumori. mi.it/INT/ProgrammaProstata/default.asp?LAR=Progetto). In a second phase the IT oncologist met FBK researchers in order to develop a model collecting structured clinical and experimental data on prostate cancer patients and to use data for outcome analysis. In the last phase computer scientists from FBK developed the e-Prostate software. The software was available in its beta-version in November 2006. Results: We developed a model describing a comprehensive approach to diagnosis and treatment of prostate PCa: patient (pt) evaluation, definition of treatment goals based on the characteristics of the cancer itself, prior treatments that the pt may or may not have received, and his priorities regarding quality-of-life issues. The clinical program is complemented by an extensive research effort, ensuring that promising laboratory advances are made available to pts in the shortest possible time frame. For each pt the whole therapeutic track is recorded in e-Prostate: pt’s demographics, relevant biochemical markers, physical exam (DRE) results, biopsies with pathological findings, diagnostic imaging studies and findings, surgical procedures with pathological findings, radiation therapy parameters, medical therapies, toxicity assessments, clinical and biochemical responses, quality of life assessments and psychological issues. e-Prostate can be used both as computerized case history and as research database. All data can be exported in spreadsheet form and in addition a graphical exploration of the data is available. Conclusions: NCIM together with FBK developed a model describing the current knowledge in PCa diagnosis and treatment. Such model was embedded in e-Prostate. This software allows data capture, control of therapeutic procedures and analysis of experimental and clinical data. The tool presented in this work is useful in clinical practice and will facilitate pts clinical evaluation and helping to bridge the gap between clinical practice and research.