Big Data Bust: MD Anderson-Watson Project Dies

Top Cancer Center Spent $62M

Nick Mulcahy

February 22, 2017

After 4 years of spiralling costs that now total at least $62 million, a grandiose big-data project that was a collaboration between MD Anderson Cancer Center and IBM's Watson artificial intelligence system is over. The details emerged in a 48-page audit report from the University of Texas System that surfaced last week in news stories.

MD Anderson is part of the larger University of Texas System, which undertook the audit over concerns about how the renowned cancer center paid millions to IBM and other project vendors.

The MD Anderson–IBM collaboration, known as the Oncology Expert Advisor, is a Watson-powered clinical guidance program designed to "continually ingest patient and research data, medical literature, and treatment options, to offer care advice," according to the report.

The "ultimate goal" of the project is "to elevate the standard of cancer care world-wide," according to the audit report, which paraphrased the project's initial leader and creator, Lynda Chin, MD, former chair of the MD Anderson Department of Genomic Medicine, who is married to the cancer center's president, Ronald DePinho, MD.

The project was "proposed…to help community oncologists provide MD Anderson-quality cancer care to patients who cannot seek treatment directly from MD Anderson physicians."

But the project never got out of Houston, where the behemoth cancer center is based, and never guided the treatment of any community-based patients.

Instead, the MD Anderson–IBM collaboration, which started in June 2012, was terminated in September 2016 while still in development.

MD Anderson's Oncology Expert Advisor is distinct from IBM's Watson for Oncology product, the content of which was largely developed at rival Memorial Sloan Kettering Cancer Center in New York City. IBM is now placing the Watson for Oncology product into cancer clinics in the United States, such as the Jupiter Medical Center in Florida, as Medscape Medical News reported earlier this month.

The Oncology Expert Advisor sought to add more information and wrinkles to the Watson platform, such as proprietary MD Anderson–specific patient data.

But the project has been plagued by huge cost overruns, the audit report reveals.

For example, version 1.0 of the Oncology Expert Advisor product focused on just one group of cancer patients — those with lower-risk myelodysplastic syndrome (MDS) leukemia. The original contract terms called for IBM to deliver the MDS leukemia product within 6 months at a fixed fee of $2.4 million. However, that contract was extended 12 times, with total contract fees of $39.2 million. (Other vendors accounted for the remaining money paid out by MD Anderson on the Oncology Expert Advisor project.) The last extension with IBM expired on October 31, 2016.

Over the course of the project, the scope of Oncology Expert Advisor grew to include five additional types of leukemia as well as lung cancer. However, no other forms of cancer were ever included in the development process.

IBM has made it clear that the Oncology Expert Advisor should not be used with patients.

The Oncology Expert Advisor "is not ready for human investigational or clinical use, and its use in the treatment of patients is prohibited," reads the audit report, quoting directly from an IBM contractual agreement with MD Anderson.

The project also apparently had a snafu related to MD Anderson's electronic medical records system.

The two Oncology Expert Advisor pilot programs (the one for leukemia and one for lung cancer, which were the only programs developed) "were conducted using the prior medical records system (ClinicStation); OEA [Oncology Expert Advisor] has not been updated to integrate with the current system (Epic)," reads the audit report.

However, the report also said that the University of Texas System's assessment of the Oncology Expert Advisor project "should not be interpreted as an opinion on the scientific basis or functional capabilities of the system in its current state." In other words, the audit was principally about money and procurement.

The report did not indicate whether any of the $62.1 million in Oncology Expert Advisor project-related expenditures played any role in large operating losses at MD Anderson in the past year. Operating budget shortfalls were the root cause of 1000 job cuts at the cancer center in January 2017, as reported by Medscape Medical News.

The audit report was posted at the University of Texas System's website on January 31, 2016, and was first reported last week by the Houston Chronicle and The Cancer Letter.

In another online news report in Forbes, IBM defended the MD Anderson product. "The Oncology Expert Advisor R&D project was a success, and likely could have been deployed had MD Anderson chosen to take it forward," said an IBM spokesperson.

Despite all of its troubles, Oncology Expert Advisor is not dead yet at MD Anderson, which is reportedly looking for a company to take on IBM's role and restart the project.

Dr Chin is no longer leading the Oncology Expert Advisor project because she left the institution in April 2015 to lead the University of Texas System's Institute for Health Transformation.

However, Dr Chin was no stranger to controversy while at MD Anderson. She was the principal investigator of an $18 million grant that was awarded in 2012 to the cancer center and Rice University in Houston for a research–business incubator project from the state-funded Cancer Prevention & Research Institute of Texas (CPRIT), which was at that time the largest grant ever awarded by the agency, as reported by Medscape Medical News.

The MD Anderson–Rice proposal was handled in a manner that has been reported as questionable: The higher-ups at CPRIT hastily processed the grant application, circumventing CPRIT scientific reviewers, according to a 2012 Houston Chronicle investigative report.

The Oncology Expert Advisor project is currently led by Joxel Garcia, MD, executive director of the cancer prevention and control platform, who joined MD Anderson in August 2015.

Follow Medscape senior journalist Nick Mulcahy on Twitter: @MulcahyNick

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