Radiotherapy Big Data
The Radiotherapy Big Data group are investigating how data is captured, used and made available during research to influence clinical delivery. Through capturing and learning from the data available, they have been able to drive new methods of radiotherapy treatment, from reduced fractionation, to adapting to the challenges presented by the COVID-19 pandemic.
When patients are treated for cancer, lots of information is recorded as part of their care. This includes data about the person, the type and stage of cancer they have, the scans taken, the treatment they receive, and importantly, the effects of this treatment on their cancer and any side effects they suffer. This information provides an opportunity to undertake research to improve how cancer is treated.
Importantly, research on data collected during normal treatment means that study results are inclusive of all the different groups of patients who need care for their cancer. It ensures that those groups who have historically often been under-represented in clinical research are not excluded.
The data can be used in different ways. It can be used to look at how well the treatment of past patients worked and provide insight about how care could be changed to improve outcomes, or to work out which types of care are best suited to which patients. This can be particularly useful when looking at how well treatments work in the long term. The data can also be used at the time of treatment to test if changes in the way patients are treated improve their outcome and experience.
Big Data Research
In Manchester, researchers from the Radiotherapy Related Research group have established a research system that allows scientific teams to safely and securely use the information collected about patients’ cancer treatments to improve care with the ultimate aim to learn from every one of the 44,000 patients treated each year at The Christie.
The information recorded about patients and their treatment is anonymised so that the patients can’t be identified and stored on a secure computer system. When a researcher working with the MCRC and The Christie identifies an important question they can apply for access to use the data stored in the system to answer it. The system has been reviewed by patient representatives, is approved by a research ethics committee, complies with strict information governance policies, and is overseen by The Christie and Health Research Authority.
The Radiotherapy Big Data team works closely with other RRR and MCRC groups. The team also collaborates with national and international experts on a range of important digital health projects, including assessment of the impact of the COVID-19 pandemic on cancer treatments.
The team is guided by the ultimate aim to provide the best care for patients, particularly for those under-represented in clinical research and to embed research that improves cancer treatment in the NHS as a normal part of every patient’s care.
Future Research Activities
The group has made some important discoveries about how cancer care could be improved using the data of patients treated at The Christie. The group is now starting to focus on how these data can be used to safely change how patients are treated with radiotherapy. Researchers will also continuously test the impact of changes on how well patients respond to their treatment using a novel approach called ‘rapid learning’. Rapid learning will allow us to test the effect of a small change in the way patients are treated, and then use the results to refine the change we made, before testing again, continuing until the treatment gives the best result for patients.
One exciting avenue of research the group involves under-represented patient groups. Many cancer patients are older and have multiple other health conditions, for example diabetes, COPD, cardiovascular disease, or hypertension. There is limited evidence about how such complex cancer patients can best be treated as they are often not included in traditional clinical research. This work will be undertaken with health and care organisation across Greater Manchester, and aims to link data at The Christie with that at hospitals and GP practices. The team will use this linked care record to find how different health needs and combinations of medicines patients take in addition to their cancer treatments can affect their outcome. This system is currently being used to work out the risks associated with COVID-19 in cancer patients.