"FileMaker Server gives the benefit of a large database to smaller groups without the need for expert database handlers or large budgets to buy expensive technology. It is not only affordable but because it is a relational database, data can be easily extracted with complex searches and analysed for trends."

Cardiff University – Department of Pathology

FileMaker Enables Pathology Research Revolution

Cardiff University is one of Britain's leading teaching and research universities. The Department of Pathology employs approximately 50 medical and scientific staff and is currently housed within the School of Medicine at the University Hospital of Wales. The department lies at the interface between basic science and medical practice. A major activity consists of research into the causes and therapy of human cancer and more recently, age-related diseases.

Dr. Griffiths undertakes research into kidney cancer and renal transplants and teaches medical students who often contribute to the research projects. He also provides a clinical histopathology service. The projects require the collation of data from different sources that then need to be analysed as a singe dataset. The traditional way of managing this process was to enter data from different sources onto separate Excel spreadsheets; which later need to be collated. This caused problems as duplicate data would be created, no more than one person could work on a single document at a time, collaboration was difficult and analysis was not possible until all data had been collated. Having multiple copies of partly duplicate data raised questions of data provenance.

Dr. Griffiths researched a number of database solutions but found the market leaders to be cumbersome and incapable of providing the flexibility needed for multiple users and the creation of data fields. Dr. Griffiths had experience of using FileMaker on his personal computer and researched the possibility of using this technology for some of the department's research and audit projects.

He found that FileMaker was easy to set up and could handle the requirements of the current studies. It also had the adequate measures of security needed when handling confidential patient information.

After a successful trial, FileMaker was put on a university server to allow students and researchers to access and contribute data to the database via either a web interface of a FileMaker client. Previously using Excel the team had to wait till everyone had finished adding in data before an analysis could be run but FileMaker allows macros to be set up to search the existing information. This allows the team to run preliminary analyses to look for inconsistencies and errors before the research is complete so the end result is more accurate.

Griffiths comments, "The data that we collate from biopsies and pathology reports can contain extensive detail that needs to be categorised into a number of fields. Adding additional fields "on the fly" is now a simple matter. By using FileMaker we know where that data is going and that the information is secure, which is imperative for complying with regulations such as the Data Protection Act."

FileMaker technology has revolutionised the pathology department in Cardiff so significantly Dr Griffiths will be presenting this solution at the bi-annual Pathology Society meeting. The presentations will be published in the Society's journal so other medical researchers at hospitals and universities can see how Cardiff Department of Pathology has overcome these challenges by using FileMaker.

Large medical research studies are often fortunate enough to qualify for grants that enable the teams to buy large-scale databases and even employ an expert who can manage the data handling of the research. For smaller research projects that are taking place in universities across the country, many do not have the resources to purchase such large-scale systems but require technology that can provide similar functions.

"FileMaker gives the benefit of a large database to smaller groups without the need for expert database handlers or large budgets to buy expensive technology. It is not only affordable but because it is a relational database, complex data can be stored, extracted and analysed," comments Dr Griffiths.

Medical students and trainee pathologists can now download directly into SPSS (a statistical programme) using an interface called ODBC, which puts a direct link between the statistical programme and FileMaker. Instead of downloading as a text file, users can read straight out of the database. This means each time an analysis is carried out, live data can be downloaded rather than working from constantly out-of-date information.

Following the success of using FileMaker technology within the pathology department, it is planned to transfer two major studies, which were started five to ten years ago, into a FileMaker database in July 2007.

In the first study, pathology and clinical results from renal cell cancer patients will be transferred so the team can examine how the treatment has affected the outcome of the cancer and what further treatment is needed.

The second study is a retrospective collation of data renal transplant patients who were involved in a trial between five and ten years ago. Data held on the current diverse systems will be transferred into FileMaker to simplify final data collection, collation and analysis. This move to a FileMaker system will be particularly important in renal transplant cases, as some patients have had more than one transplant and therefore more than one biopsy result.

FileMaker allows these relationships to be set up logically ensuring there is no duplication of data and allowing appropriate searching. The database will allow analysis of how findings in early biopsies influence the outcome so providing clues as to what treatment we might use in the future to improve the survival of renal transplants.