A new standardized data collection system for interdisciplinary thyroid cancer management: Thyroid COBRA

Published:February 21, 2018DOI:


      • Big data approach represents an alternative to EBM for thyroid cancer management.
      • The thyroid COBRA-Storage System (C-SS) is not time-consuming and privacy respecting.
      • The development of the C-SS through a multicentre consortium approach is feasible.
      • The thyroid C-SS can be applied in the near future to every cancer type.


      The big data approach offers a powerful alternative to Evidence-based medicine. This approach could guide cancer management thanks to machine learning application to large-scale data. Aim of the Thyroid CoBRA (Consortium for Brachytherapy Data Analysis) project is to develop a standardized web data collection system, focused on thyroid cancer.
      The Metabolic Radiotherapy Working Group of Italian Association of Radiation Oncology (AIRO) endorsed the implementation of a consortium directed to thyroid cancer management and data collection. The agreement conditions, the ontology of the collected data and the related software services were defined by a multicentre ad hoc working-group (WG).
      Six Italian cancer centres were firstly started the project, defined and signed the Thyroid COBRA consortium agreement. Three data set tiers were identified: Registry, Procedures and Research. The COBRA-Storage System (C-SS) appeared to be not time-consuming and to be privacy respecting, as data can be extracted directly from the single centre's storage platforms through a secured connection that ensures reliable encryption of sensible data. Automatic data archiving could be directly performed from Image Hospital Storage System or the Radiotherapy Treatment Planning Systems.
      The C-SS architecture will allow “Cloud storage way” or “distributed learning” approaches for predictive model definition and further clinical decision support tools development.
      The development of the Thyroid COBRA data Storage System C-SS through a multicentre consortium approach appeared to be a feasible tool in the setup of complex and privacy saving data sharing system oriented to the management of thyroid cancer and in the near future every cancer type.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Marr B.
        How big data is changing healthcare.
        Forbes. Apr 21, 2015;
        • Sim I.
        Two ways of knowing: big data and evidence based medicine.
        Ann Intern Med. 2016; 164: 562-563
        • Franceschi S.
        • Vaccarella S.
        Thyroid cancer: an epidemic of disease or an epidemic of diagnosis?.
        Int J Cancer. 2015; 136: 2738-2739
        • International Agency for Research on Cancer
        GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012.
        • Rinaldi S.
        • Lise M.
        • Clavel-Chapelon F.
        • et al.
        Body size and risk of differentiated thyroid carcinomas: findings from EPIC study.
        Int J Cancer. 2012; 131: E1004-14
        • Dal Maso L.
        • Bosetti C.
        • La Vecchia C.
        • Franceschi S.
        Risk factors for thyroid cancer: an epidemiological review focused on nutritional factors.
        Cancer Causes Control. 2009; 20: 75-86
        • Pellegriti G.
        • De Vathaire F.
        • Scollo C.
        • et al.
        Papillary thyroid cancer incidence in the volcanic area of Sicily.
        J Natl Cancer Inst. 2009; 101: 1575-1583
        • Hundahl S.A.
        • Fleming I.D.
        • Fremgen A.M.
        • Menck H.R.
        A national cancer database report on 53,856 cases of thyroid carcinoma treated in the US, 1985–1995.
        Cancer. 1998; 83: 2638-2648
        • Mazzaferri E.L.
        • Jhiang S.M.
        Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer.
        Am J Med. 1994; 97: 418-428
        • American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer
        • Cooper D.S.
        • Doherty G.M.
        • et al.
        Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer.
        Thyroid. Nov 2009; 19: 1167-1214
        • Haugen B.R.
        • Alexander E.K.
        • Bible K.C.
        • et al.
        2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer.
        Thyroid. 2016; 26: 1-133
        • Tufano R.P.
        • Teixeira G.V.
        • Bishop J.
        • Carson K.A.
        • Xing M.
        BRAF mutation in papillary thyroid cancer and its value in tailoring initial treatment: a systematic review and meta-analysis.
        Medicine (Baltimore). 2012; 91: 274-286
        • Mallick U.
        • Harmer C.
        • Yap B.
        • et al.
        Ablation with low-dose radioiodine and thyrotropin alpha in thyroid cancer.
        N Engl J Med. 2012; 366: 1674-1685
        • Schlumberger M.
        • Catargi B.
        • Borget I.
        • et al.
        Strategies of radioiodine ablation in patients with low-risk thyroid cancer.
        N Engl J Med. 2012; 366: 1663-1673
        • Zietman A.L.
        Falsification, fabrication, and plagiarism: the unholy trinity of scientific writing.
        Int J Radiat Oncol Biol Phys. 2013; 87: 225-227
        • Booth C.M.
        • Tannock I.F.
        Randomised controlled trials and population-based observational research: partners in the evolution of medical evidence.
        Br J Cancer. 2014; 110: 551-555
        • Tagliaferri L.
        • Kovács G.
        • Autorino R.
        • et al.
        ENT COBRA (Consortium for Brachytherapy Data Analysis): interdisciplinary standardized data collection system for head and neck patients treated with interventional radiotherapy (brachytherapy).
        J Contemp Brachytherapy. 2016; 8: 336-343
        • Wilson J.M.
        Gantt charts: a centenary appreciation.
        Eur J Oper Res. 2003; 149: 430-437
        • Meldolesi E.
        • van Soest J.
        • Alitto A.R.
        • et al.
        VATE: VAlidation of high TEchnology based on large database analysis by learning machine.
        Colorect Cancer. 2014; 3: 435-450
        • Parmar C.
        • Leijenaar R.T.
        • Grossmann P.
        • et al.
        Radiomic feature clusters and prognostic signatures specific for lung and head & neck cancer.
        Sci Rep. 2015; 5: 11044
        • Valentini V.
        • Maurizi F.
        • Tagliaferri L.
        • et al.
        Spider: managing clinical data of cancer patients treated through a multidisciplinary approach by a palm based system.
        JPH. 2008; 5
        • Skripcak T.
        • Belka C.
        • Bosch W.
        • et al.
        Creating a data exchange strategy for radiotherapy research: towards federated databases and anonymised public datasets.
        Radiother Oncol. 2014; 113: 303-309