Data Visualization Support for Interdisciplinary Team Treatment Planning in Clinical Oncology: Scoping Review

Abstract

Background: Complex and expanding datasets in clinical oncology applications require flexible and interactive visualization of patient data to provide physicians and other medical professionals with maximum amount of information. In particular, interdisciplinary tumor conferences profit from customized tools to integrate, link, and visualize relevant data from all professions involved.

Objective: Our objective was to identify and present currently available data visualization tools for tumor boards and related areas. We wanted to provide an overview of not only the digital tools currently used in tumor board settings but also of the data they include, their respective visualization solutions, and their integration into hospital processes.

Methods: This scoping review was based on the scoping study framework by Arksey and O'Malley and attempted to answer the following research question: "What are the key features of data visualization solutions used in molecular and organ tumor boards, and how are these elements integrated and used within the clinical setting?" The following electronic databases were searched for articles: PubMed, Web of Science, and Scopus. Articles were deemed eligible if published in English in the last 10 years. Eligible articles were first deduplicated, followed by screening of titles and abstracts. Full-text screening was then conducted to decide on article selection. All included articles were analyzed using a data extraction template. The template included a variety of meta-information, as well as specific fields aiming to answer the research question.

Results: The review process started with 2049 articles, of which 1014 (49.49%) were included in the title and abstract screening. A total of 5.47% (112/2049) of the publications were eligible for full-text screening, leading to 2.93% (60/2049) of the publications being eligible for final inclusion. They covered 49 distinct visualization tools and applications. We discovered a variety of innovative visualization solutions, most often driven by the complexity of omics data, represented in 96% (47/49) of the tools. Tables remained the most used tool for the visualization of data types described in the articles. Approximately one-third of the identified tools (16/49, 33%) were systematically evaluated in some form. For most discovered tools (37/49, 76%), there was no documentation of implementation into the clinical routine. A significant number of applications (21/49, 43%) were available through open-source access.

Conclusions: There is a wide range of projects providing visualization solutions for tumor boards and clinical oncology applications. Among the few tools that have made their way into clinical routine settings, there are both commercial and academic solutions. While tables for a variety of data types remain the dominant visualization strategy, the complexity of omics data appears to be the driving force behind many visualization innovations in the domain of tumor boards.

International registered report identifier (irrid): RR2-10.2196/53627.

Keywords: cancer conference; clinical oncology; multidisciplinary; scoping review; software; tumor; tumor board; visualization.

Figure 1

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart [36]. Removal of duplicate records and records removed through automation tools before screening are overlapping categories.

Figure 2

Data type overview. Filled fields represent the existence of visualization for the data type. FLEX rows represent generalized visualization solutions for the category that can be primarily used through user-defined data. CNV: Copy Number Variation; DICOM: Digital Imaging and Communications in Medicine; SNV: single nucleotide variant. Tool acronyms: AMBAR (Alteration Annotations For Molecular Tumor Boards), AMLVaran (AML Variant Analyzer), ChiBE (Chisio BioPAX Editor), CGC (Cancer Genomics Cloud), CVE (Cancer Variant Explorer), MTB report (From somatic variants towards precision oncology: Evidence-driven reporting of treatment options in molecular tumor boards), GEPIA (Gene Expression Profiling Interactive Analysis), MOPAW (Multi-omics Pathways Workflow), MTBP (Molecular Tumor Board Portal), MTPpilot (Molecular Tumor Profiling pilot), NTB (NAVIFY Tumor Board), Novel MTB Support Tool (User-Driven Development of a Novel Molecular Tumor Board Support Tool), Breast Tumor Board (A Digital Solution for an Advanced Breast Tumor Board: Pilot Application Cocreation and Implementation Study), PeCaX (personalized cancer network explorer), SEER (Surveillance, Epidemiology and End Results), TarPan Viewer (Targeted Panel Viewer), VMTB (virtual molecular tumor board).

Figure 3

Distribution of the data types and visualization strategies for patient-related data.

Figure 4

Distribution of data types and visualization strategies for omics data. CNV: copy number variation; SNV: single nucleotide variant.

Figure 5

Distribution of the data types and visualization strategies for miscellaneous data.

Figure 6

Tool category examples: (A) Joint data visualization in oncothreads; (B) Organizational visualization through the Molecular Tumor Board-cBioPortal recommendation documentation; (C) Multi-tool integration in the cBioPortal pathway view; (D) Specialized visualization using the University of California Santa Cruz Genome Browser.