Providing access to risk prediction tools via the HL7 XML-formatted risk web service

Abstract

Background Cancer risk prediction tools provide valuable information to clinicians but remain computationally challenging. Many clinics find that Ca Gene or Hughes Risk Apps fit their needs for easy- and ready-to-use software to obtain cancer risks; however, these resources may not fit all clinics’ needs. The Hughes Risk Apps Group and Bayes Mendel Lab therefore developed a web service, called “Risk Service", which may be integrated into any client software to quickly obtain standardized and up-to-date risk predictions for Bayes Mendel tools (BRCAPRO, MMRpro, PancPRO, and MelaPRO), the Tyrer-Cuzick IBIS Breast Cancer Risk Evaluation Tool, and the Colorectal Cancer Risk Assessment Tool. Findings Software clients that can convert their local structured data into the HL7 XML-formatted family and clinical patient history (Pedigree model) may integrate with the Risk Service. The Risk Service uses Apache Tomcat and Apache Axis2 technologies to provide an all Java web service. The software client sends HL7 XML information containing anonymized family and clinical history to a Dana-Farber Cancer Institute (DFCI) server where it is parsed, interpreted, and processed by multiple risk tools. The Risk Service then formats the results into an HL7 style message and returns the risk predictions to the originating software client. Upon consent, users may allow DFCI to maintain the data for future research. The Risk Service implementation is exemplified through Hughes Risk Apps. Conclusions The Risk Service broadens the availability of valuable, up-to-date cancer risk tools and allows clinics and researchers to integrate risk prediction tools into their own software interface designed for their needs. Each software package can collect risk data using its own interface, and display the results using its own interface, while using a central, up-to-date risk calculator. This allows users to choose from multiple interfaces while always getting the latest risk calculations. Consenting users contribute their data for future research, thus building a rich multi-center resource.

Review and Comparison of Electronic Patient‐Facing Family Health History Tools

“…A prenatal version also has been developed but is not yet commercially available (Edelman et al, 2014; Lin et al, 2013). Of note, the founders have done extensive work to establish FHx standards for interoperability and decision support (Chipman et al, 2013; Health Level 7 Clinical Genomics Work Group, 2013). In 2015, HughesRiskApps secured investment and changed its name to CRA Health.…”

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces

“…We sought to develop a modular application to extract data, perform calculations, and display CDS recommendations in a manner that would address real-world constraints of ambulatory practices 8 . In this study, we developed a stand-alone CDS application for kidney failure risk prediction as a case study of CDS using Health Level 7 (HL7) interoperability standards 9 , 10 …”

On the Use of XML in Medical Imaging Web-Based Applications

“…The system facilitated management of XML schemes and on-demand creation and management of XML databases that conform to those schemes. Recently, Chipman et al [56] presented a software that can convert local structured data into XML-formatted data. Hence, while clinicians and patients benefit greatly from readily available risk predictions, a large pool of multiinstitutional family history data will be continually gathered.…”