Abstract

BackgroundThe analytical capacity and speed of next-generation sequencing (NGS) technology have been improved. Many genetic variants associated with various diseases have been discovered using NGS. Therefore, applying NGS to clinical practice results in precision or personalized medicine. However, as clinical sequencing reports in electronic health records (EHRs) are not structured according to recommended standards, clinical decision support systems have not been fully utilized. In addition, integrating genomic data with clinical data for translational research remains a great challenge.ObjectiveTo apply international standards to clinical sequencing reports and to develop a clinical research information system to integrate standardized genomic data with clinical data.MethodsWe applied the recently published ISO/TS 20428 standard to 367 clinical sequencing reports generated by panel (91 genes) sequencing in EHRs and implemented a clinical NGS research system by extending the clinical data warehouse to integrate the necessary clinical data for each patient. We also developed a user interface with a clinical research portal and an NGS result viewer.ResultsA single clinical sequencing report with 28 items was restructured into four database tables and 49 entities. As a result, 367 patients’ clinical sequencing data were connected with clinical data in EHRs, such as diagnosis, surgery, and death information. This system can support the development of cohort or case-control datasets as well.ConclusionsThe standardized clinical sequencing data are not only for clinical practice and could be further applied to translational research.

Highlights

  • Much research has been conducted to find new biological markers for diagnosis or treatment as next-generation sequencing (NGS) technologies have improved [1]

  • We extended a clinical NGS research system (CNRS) in a clinical research data warehouse (CRDW) that structures and standardizes clinical sequencing results by mapping standard terminology from current unstructured text reports

  • From April 2017 to February 2019, the CNRS included 367 clinical sequencing results, which consisted of 249 lung cancer cases, 70 ovarian cancer cases, eight breast cancer cases, seven malignant melanoma cases, seven colon cancer cases, seven stomach cancer cases, six liver cancer cases, five thyroid cancer cases, five kidney cancer cases, two brain cancer cases, and one prostate cancer case

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Summary

Introduction

Much research has been conducted to find new biological markers for diagnosis or treatment as next-generation sequencing (NGS) technologies have improved [1]. Objective: To apply international standards to clinical sequencing reports and to develop a clinical research information system to integrate standardized genomic data with clinical data. Methods: We applied the recently published ISO/TS 20428 standard to 367 clinical sequencing reports generated by panel (91 genes) sequencing in EHRs and implemented a clinical NGS research system by extending the clinical data warehouse to integrate the necessary clinical data for each patient. 367 patients’ clinical sequencing data were connected with clinical data in EHRs, such as diagnosis, surgery, and death information. This system can support the development of cohort or case-control datasets as well. Conclusions: The standardized clinical sequencing data are for clinical practice and could be further applied to translational research

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