eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 10
Review paper

ENT COBRA ONTOLOGY: the covariates classification system proposed by the Head & Neck and Skin GEC-ESTRO Working Group for interdisciplinary standardized data collection in head and neck patient cohorts treated with interventional radiotherapy (brachytherapy)

Luca Tagliaferri
Ashwini Budrukkar
Jacopo Lenkowicz
Mauricio Cambeiro
Francesco Bussu
Jose Luis Guinot
Guido Hildebrandt
Bengt Johansson
Jens E. Meyer
Peter Niehoff
Angeles Rovirosa
Zoltán Takácsi-Nagy
Luca Boldrini
Nicola Dinapoli
Vito Lanzotti
Andrea Damiani
Roberto Gatta
Bruno Fionda
Valentina Lancellotta
Tamer Soror
Rafael Martìnez Monge
Vincenzo Valentini
György Kovács

J Contemp Brachytherapy 2018; 10, 3: 260–266
Online publish date: 2018/06/30
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Clinical data collecting is expensive in terms of time and human resources. Data can be collected in different ways; therefore, performing multicentric research based on previously stored data is often difficult. The primary objective of the ENT COBRA (COnsortium for BRachytherapy data Analysis) ontology is to define a specific terminological system to standardized data collection for head and neck (H&N) cancer patients treated with interventional radiotherapy.

Material and methods
ENT-COBRA is a consortium for standardized data collection for H&N patients treated with interventional radiotherapy. It is linked to H&N and Skin GEC-ESTRO Working Group and includes 11 centers from 6 countries. Its ontology was firstly defined by a multicentric working group, then evaluated by the consortium followed by a multi-professional technical commission involving a mathematician, an engineer, a physician with experience in data storage, a programmer, and a software expert.

Two hundred and forty variables were defined on 13 input forms. There are 3 levels, each offering a specific type of analysis: 1. Registry level (epidemiology analysis); 2. Procedures level (standard oncology analysis); 3. Research level (radiomics analysis). The ontology was approved by the consortium and technical commission; an ad-hoc software architecture (“broker”) remaps the data present in already existing storage systems of the various centers according to the shared terminology system. The first data sharing was successfully performed using COBRA software and the ENT COBRA Ontology, automatically collecting data directly from 3 different hospital databases (Lübeck, Navarra, and Rome) in November 2017.

The COBRA Ontology is a good response to the multi-dimensional criticalities of data collection, retrieval, and usability. It allows to create a software for large multicentric databases with implementation of specific remapping functions wherever necessary. This approach is well-received by all involved parties, primarily because it does not change a single center’s storing technologies, procedures, and habits.


data collection, ENT-COBRA, head and neck cancer, GEC-ESTRO, personalized medicine

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