ASCO Harnesses 'Big Data' for Cancer Care

Roxanne Nelson

March 28, 2013

"Big data" hold great promise in the improvement of healthcare for all patients. In the latest example of emerging efforts to use sophisticated technology, the American Society of Clinical Oncology (ASCO) has announced the completion the CancerLinQ prototype.

CancerLinQ can help physicians track and improve the quality of care in real time, before they make a suboptimal choice, experts told journalists at a panel discussion hosted by ASCO at the National Press Club in Washington, DC.

"We are on the cusp of information technology in cancer care," said ASCO president Sandra M. Swain, MD, noting that there has been "a revolution and evolution in cancer care."

Dr. Swain, who is also the medical director of MedStar Washington Hospital Center, Washington Cancer Institute, in DC, pointed out more than 60% of oncology practices are already using advanced electronic medical record systems; only 8% of practices are not using any electronic system.

With CancerLinQ, data can be collected directly from oncology practices. The computer network collects and analyzes cancer care data from millions of patient visits, incorporates expert guidelines and other evidence, and generates real-time, real-world personalized guidance and quality feedback for oncologists.

Currently, only 3% of patients participate in clinical trials, Dr. Swain noted. CancerLinQ aims to harness the information of the other 97% of patients by collecting data directly from practices. It would be as if all cancer patients are taking part in a trial, she explained.

First Step Completed

Dr. Swain explained that the first step in this project has been completed. The prototype was built to "show that this is possible and to provide proof of principle," she said. The prototype has data from more than 100,000 breast cancer patients who were treated at leading cancer care institutions in the United States.

She noted that this type of data system is not limited to oncology; it can be used for other diseases as well. Its success will confirm the notion that every patient can add to the knowledge base.

Core Functions of the CancerLinQ Prototype

The CancerLinQ prototype can accept any cancer care data in real time, in any form, directly from electronic health records and other sources.

It can also provide clinical decision support. It generates individualized guidance on the care of any patient with breast cancer, based on automated machine-readable versions of ASCO's expert breast cancer guidelines.

Using data mining and visualization, the prototype can explore an extensive database of information on breast cancer management, patient characteristics, treatments, and outcomes. This will identify 'real-world' trends and associations and generate new hypotheses for research.

In addition, the prototype provides immediate quality feedback on physician performance, by evaluating it against 10 quality measures from ASCO's Quality Oncology Practice Initiative.

Bringing in Physician Leadership

Panelist Clifford A. Hudis, MD, who is president-elect of ASCO, agrees that the prototype "proves that what we want to do can be done."

"We aimed for 30,000 patients and now are at 130,000," said Dr. Hudis, who is also chief of the breast cancer medicine service at the Memorial Sloan-Kettering Cancer Center in New York City. "This means that our community is very supportive and willing to supply their records to us."

Panelist Lynn Etheredge, director of the rapid learning project at George Washington University in Washington, DC, noted that CancerLinQ brings physician leadership into patient care. "We have been missing physician leadership in a lot of the talk of healthcare reform," he said.

CancerLinQ will help empower physicians to do a better job and give them better tools. Etheredge noted that the healthcare system is constantly evolving, and someone had to show that such a system can work. "It is like going to the moon. Theorists like myself were confident it could be done," it just had to happen, he explained.

The prototype is just the first step in what is going to be a long process, Dr. Hudis noted. "We will have a full build that will take on all of oncology. We will need the support of experts and the community. Because of the early success of the prototype, we anticipate that the community will rally around us and support us."