Computer support for protocol-based treatment of cancer

Cancer treatment is often carried out within protocol-based clinical trials. An oncology clinic may take part in many trials each of which requires data to be collected for monitoring efficacy and toxicity of treatment. Subsequently, this data is analysed statistically to evaluate clinical objectives of the trial. To be scientifically valid, such analysis must be based on data that is both complete and correct. This is one motivating factor for introducing computer support for trial management. Further motivation is provided by concern that treatment is consistent with the protocol and the well-being of the patient. The complexity of many protocols, the life-threatening nature of cancer and the toxicity of treatment side-effects emphasise the safety-critical nature of oncology. The OaSiS system provides decision support for the protocol-based treatment of cancer patients with emphasis on the safety aspects of the advice it gives. It offers a highly graphical interface, employs integrity constraint checking techniques from logic databases to monitor compliance with a protocol and is implemented in PROLOG. The paper describes the main features of OaSiS and indicates work in progress and planned. 1

Computer Support For Protocol-Based Treatment Of Cancer

This paper focuses on the current functionality of OaSiS and discusses the use of safety related knowledge identified from an extensive study of oncology protocols and from discussions with clinicians, pharmacists and medical informaticians. The safety critical nature of the domain imposes requirements on software designers and implementers to ensure that the translation from paper to computerised protocol is completed thoroughly and correctly [9]. OaSiS has been implemented within RED, a project funded by the UK DTI and SERC "Safety Critical Systems" research programme. A major influence on OaSiS is the work at Stanford University on the ONCOCIN [32], EON [26] and OPAL [25] family of computer systems. In the OaSiS prototype, this is particularly evident in the user interface and its combined use of graphical, form-based 1 An earlier version of this paper was presented at the 2nd International Conference on the Practical Application of PROLOG, London, 1994.