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IKTPLUSS-IKT og digital innovasjon

AI-Powered Testing Infrastructure for Cancer Registry System

Alternative title: Bruk av AI i testing av infrastruktur i et kreftregister

Awarded: NOK 7.0 mill.

The Cancer Registration Support System (CaReSS) at the Cancer Registry of Norway has been handling information on cancer since 1952. The system has gone thru several upgrades and are now fully digital. All health personnel diagnosing or treating cancer patients are obliged by law to report to the Cancer Registry, and in addition data from other registries are collected. All patient information is submitted to the system and curated by trained medical coders. They create patient histories by piecing together all this information into patient histories, which are timelines of the patient's diagnostic workup, treatments, and follow-up. Hundreds of rules have been defined to validate the data. These rules are manually reviewed to ensure that patient histories are correct. New rules are constantly introduced, and existing rules are frequently revised due to new medical findings. Dependencies between rules, such as ordering and timing, also exist. The automated checking of rules is an ideal solution to improve the quality of patient history. However, not only are the rules changing over time, but also the data as diagnostics and treatment are improved. This leads to the continuous evolution of the CaReSS's key software components, to ensure that such data structures and rules are correctly specified and implemented. Thus, there is a need for a cost-effective, systematic, and automated testing layer, i.e., new testing methods implemented in a software testing tool and a test execution infrastructure?the innovation planned in this project. This innovation is expected to have a long-term impact (of several decades at least) on the quality of data that the system can provide to end-users (e.g., patients, researchers, doctors, and government officials), as the data in the Cancer Registry is used in medical research and evaluation of health services. In 2021, the Cancer Registry har performed preparatory work on the Caress system, configuring and set-up of a new testing environment, and doing the first benchmarking on the current Caress system. The research focus has been on domain analysis, and scientific researchers familiarizing with the current Caresses system.


The Cancer Registry of Norway (CRN) collects data about cancer patients, e.g., about diagnostic, treatment, and follow-up, and provide this data and statistics to its end users, e.g., researchers, patients, doctors, and health authorities. Decisions, regarding how this data should be coded rely on a semi-automated and interactive decision support system, named as Cancer Registration Support System (CaReSS). The system uses a patient’s test results and treatments, and makes decisions, based on medical coding rules, often using machine learning. CaReSS evolves due to, e.g., addition, deletion, and modification of rules due to new treatments, improved diagnostics, new medical results and tests, and new diagnostic standards. Also, CRN continuously updates CaReSS with advanced versions of machine learning algorithms. Thus, the implementation of CaReSS undergoes continuous change and warrants continuous, cost-effective testing of CaReSS as it evolves. A well-test CaReSS will prevent the system from producing inaccurate statistics and data to its end users. Inaccurate or imprecise data produced by CaReSS have significant adverse effects on the scientific results produced by researchers. Also, inaccurate or imprecise statistics produced by the CaReSS will significantly impact the decisions made by patients, hospitals, and policymakers. The innovation planned is a state-of-the-art test infrastructure including new testing techniques to support cost-effective and systematic testing of the CaReSS to significantly improve its quality, and quality of data and statistics it produces, by dealing with the continuous evolution and unpredictable behavior of machine learning algorithms. This will positively affect all its end users, including researchers, patients, doctors, and government officials. The deployment of the new testing infrastructure at CRN will lead to significant improvements in the current testing practice at CRN.

Funding scheme:

IKTPLUSS-IKT og digital innovasjon