Web links cancer patients to drug trials
October 14, 1998
by Sharon Machlis
(IDG) -- An extranet connecting physicians with pharmaceutical company data is helping hundreds of doctors find new cancer drugs for their patients.
Linking data about patients and drug tests may seem simple enough. But in the paper-based world of health care, using a database to cross-match patient symptoms with ongoing drug trials is a major technology leap.
"It sounds bizarre when you tell people how things are done in health care, because it's so archaic," said Dr. John Benear, president of Cancer Care Associates, an oncology practice in Tulsa, Okla.
For example, many patients who might benefit from drugs in clinical trials today may have to rely on luck. It's often a matter of chance that a doctor reads about the particular trial, remembers the project and thinks of a particular patient as an ideal candidate.
Each of the more than 300 new cancer-fighting drugs that pharmaceutical companies are expected to introduce this year must first be tested in limited trials before the federal government will approve them for general use. And there are another 1,000 or so in the pipeline.
But finding patients who might benefit from participating in trials of new drugs hasn't been easy, because doctors typically keep track of such new tests with paper lists. Then they try to match patients in their practice with the drug tests in progress Ñ sometimes leaving patients in mid-exam to check lists.
"No doctor can keep in his mind all these trials," Benear said. Now, less than than 5% of all adult cancer patients participate in drug trials, even though Benear believes many of the new drugs are likely to be helpful. (Pharmaceutical companies are getting better at targeting their research, he said.)
"It's a very sad reflection," said Bill McKeon, vice president of American Oncology Resources, Inc. (AOR), a medical management company in Houston that helps its doctors participate in drug trials. "[World Wide] Web-based applications and databases were a perfect solution for this."
Working with TVisions, a Cambridge, Mass., Internet consulting firm, AOR developed a database for clinical drug trials. Physicians in AOR's network enter basic demographic information about each cancer patient (gender and age, for example), where in the body the cancer is located and what stage the disease is in. The data is already in a patient's regular file but is entered separately into the new AOR extranet system, called SecureNet, which is open only to doctors who use AOR's services. Benear said the data-entry takes little additional time.
Each time AOR learns of a new drug trial, information about the trial is entered in the system, which then scans all patient information for preliminary matches. Doctors are E-mailed if any of their patients might match the trial.
Patients can decide if they want to try a new therapy. Under the old system, McKeon said, some patients who decided to participate in trials found that the projects had closed by the time all the paperwork was filled out. With SecureNet, physicians can be notified when a trial program is full Ñ or tell patients that they probably need to decide quickly because only a few slots are left.
For security and privacy reasons, all information going in and out of the database is encrypted, and only a patient's initials and identification number (not a Social Security number) are entered into the database, which is accessed over the Internet, said Ralph Folz, president of TVisions.
"It's allowed us to participate in trials we wouldn't have otherwise found," said Benear, an early beta tester of SecureNet. And he can cite at least one patient he believes "would not be alive if she couldn't get into a research trial."
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