PT  - JOURNAL ARTICLE
AU  - Arturo López-Pineda, PhD
AU  - Mario F. Rodríguez-Moran MD
AU  - Cleto Álvarez-Aguilar, MD, MS
AU  - Sarah M. Fuentes Valle MD
AU  - Román Acosta-Rosales
AU  - Ami S. Bhatt, MD, PhD
AU  - Shruti N. Sheth MD
AU  - Carlos D. Bustamante, PhD
TI  - Data mining of digitized health records in a resource-constrained setting reveals that timely immunophenotyping is associated with improved breast cancer outcomes
AID  - 10.1101/198721
DP  - 2018 Jan 01
TA  - bioRxiv
PG  - 198721
4099  - http://biorxiv.org/content/early/2018/02/14/198721.short
4100  - http://biorxiv.org/content/early/2018/02/14/198721.full
AB  - Background Organizations that issue guidance on breast cancer recommend the use of immunohistochemistry (IHC) for providing appropriate and precise care. However, little focus has been directed to the identification of maximum allowable turnaround times for IHC, which is necessary given the diversity of hospital settings in the world. Much less effort has been committed to the development of digital tools that allow hospital administrators to monitor service utilization histories of their patients.Methods In this retrospective cohort study, we reviewed electronic and paper medical records of all suspected breast cancer patients treated at one secondary-care hospital of the Mexican Institute of Social Security (IMSS), located in western Mexico. We then followed three years of medical history of those patients with IHC testing.Findings In 2014, there were 402 breast cancer patients, of which 30 were tested for some IHC biomarker (ER, PR, HER2). The subtyping allowed doctors to adjust (56·7 %) or confirm (43·3 %) the initial therapeutic regimen. The average turnaround time was 56 days. Opportune IHC testing was found to be beneficial when it was available before or during the first rounds of chemotherapy.Interpretation The use of data mining tools applied to health record data revealed that there is an association between timely immunohistochemistry and improved outcomes in breast cancer patients. Based on this finding, inclusion of turnaround time in clinical guidelines is recommended. As much of the health data in the country becomes digitized, our visualization tools allow a “digital dashboard” of the hospital service utilization histories.Funding Clinically Relevant Genome Variation Database (ClinGen); and UCSF–Stanford Center of Excellence in Regulatory Science and Innovation (CERSI).