title: A meta-model of chemotherapy planning in the multi-hospital/multi-trial-center-environment of pediatric oncology.
abstract: OBJECTIVE
  Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the calculation according to state-of-the-art research is crucial for curing the child. Computer-assistance can be of great value. The objective of our research was to work out a meta-model of chemotherapy planning based on the Unified Modeling Language (UML). The meta-model is used for the development of an application system which serves as a knowledge-acquisition tool for chemotherapy protocols in pediatric oncology as well as for providing protocol-based care.
  
  
  METHODS
  We applied evolutionary prototyping, software reengineering techniques and grounded theory, a qualitative method in social research. We repeated the following steps several times over the years: Based on a requirements analysis (i) a meta-model was developed or adapted, respectively (ii). The meta-model served as a basis for implementing evolutionary prototypes (iii). Further requirements were identified (i) from clinical use of the systems.
  
  
  RESULTS
  We developed a comprehensive UML-based meta-model for chemotherapy planning in pediatric oncology (chemoMM). We implemented it and introduced evolutionary prototypes (CATIPO and DOSPO) in several medical centers. Systematic validation of the prototypes enabled us to derive a final meta-model which covers the requirements that have turned out to be necessary in clinical routine.
  
  
  CONCLUSIONS
  We have developed an application system that fits well into clinical routine of pediatric oncology in Germany. Validation results have shown that the implementation of the meta-model chemoMM can adequately support the knowledge acquisition process for protocol-based care.
authors.affiliation: Department of Medical Informatics, Institute for Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. sebastian.garde@med.uni-heidelberg.de
authors.forename: S
authors.initials: S
authors.lastname: Garde
authors.forename: B
authors.initials: B
authors.lastname: Baumgarten
authors.forename: O
authors.initials: O
authors.lastname: Basu
authors.forename: N
authors.initials: N
authors.lastname: Graf
authors.forename: R
authors.initials: R
authors.lastname: Haux
authors.forename: R
authors.initials: R
authors.lastname: Herold
authors.forename: U
authors.initials: U
authors.lastname: Kutscha
authors.forename: F
authors.initials: F
authors.lastname: Schilling
authors.forename: B
authors.initials: B
authors.lastname: Selle
authors.forename: C
authors.initials: C
authors.lastname: Spiess
authors.forename: T
authors.initials: T
authors.lastname: Wetter
authors.forename: P
authors.initials: P
authors.lastname: Knaup
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005858:Germany; D006801:Humans; D009096:Multi-Institutional Systems / Q000458:organization & administration*; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D010372:Pediatrics; D013813:Therapy, Computer-Assisted
chemical_list: D000970:Antineoplastic Agents