Assaf Halevy (2bPrecise) The Last Clinical Mile of Precision Medicine: Challenges at the Point of Care #PMWC17
12:03pm January 24th 2017 via Hootsuite
Komatsoulis: EMR interfaces (about a dozen), 1M pts w/ >800M reported events. '17 goals: reporting, first delivery of 'Discovery db' #PMW
11:48am January 24th 2017 via Hootsuite
Komatsoulis: Implemented in HANA (SAP cloud), showed dashboard. 1.6M pts total, 76 participating institutions; >2K oncologists #PMWC17
11:46am January 24th 2017 via Hootsuite
Komatsoulis: They extract from EMR, to clinical DB, to de-ID analytical DB, human curation to a 'Discovery db' w/partner requests #PMWC17
11:45am January 24th 2017 via Hootsuite
Komatsoulis: IOM, ASCO launched CancerLinQ: to learn from every pt, to harness clinical practice data, to support practicioners #PMWC17
11:42am January 24th 2017 via Hootsuite
Komatsoulis: And 90% of NCI trials are white, vs 23% of the US population is non-white (i.e. 77%) #PMWC17
11:40am January 24th 2017 via Hootsuite
Komatsoulis: Older - 25% are >65% vs 61% of the 'normal' cancer population. 40% of kidney cancer pts too sick for trials #PMWC17
Komatsoulis: 1.7M diagnosed/y w/cancer, 3%, 50K enroll in trials. The 97%: older, less healthy, more diverse. #PMWC17
11:39am January 24th 2017 via Hootsuite
Komatsoulis: Shows example of types and distribution of genes mutated in B-cell, T-cell lineage across adults, youth #PMWC17
11:38am January 24th 2017 via Hootsuite
Komatsoulis: Complex circuitry means multiple genes. 'Cancer is a set of diseases in the molecular circuits that control cells' #PMWC17
11:37am January 24th 2017 via Hootsuite
Komatsoulis: Points to Hanahan Hallmarks figure (Cell 2000), evading apoptosis, angiogenesis; invasion & metastasis. #PMWC17
11:36am January 24th 2017 via Hootsuite
Komatsoulis: Evidence of cancerous tumor in fossil of a 1.7M year old human CNN story https://t.co/I05N5bEFEb #PMWC17
11:35am January 24th 2017 via Hootsuite
George Komatsoulis (CancerLinQ, ASCO) Big Data in Cancer Care #PMWC17
11:33am January 24th 2017 via Hootsuite
Q (con't) Abernethy: A high-trust dataset is returned back, with academic partner's own controls. #PMWC17
Q: How is data protected? Gross: De-identified, minimal amount of info is distributed back to academic partners. Full charts go in #PMWC17
11:31am January 24th 2017 via Hootsuite
Gross: Also survival analysis, if NGS improved outcomes. Lessons: shared governance impt. Master Services Agreement, priorities #PMWC17
11:26am January 24th 2017 via Hootsuite
Gross: NGS: tend to be younger, less minority and wealthier and showed data from their dataset. Next: looking at findings #PMWC17
11:25am January 24th 2017 via Hootsuite
Gross: Pointed to this NYT piece on minority hurdles to access immunotherapy. https://t.co/3U3CDmuzSE #PMWC17
Gross: Data on NSCLC, melanoma, kidney cancers. Preface: doctors typically very slow to adopt new Rx. Showed impact of approval #PMWC17
11:24am January 24th 2017 via Hootsuite
Gross: Two projects - immunoRx and NGS. Looked at 2 PD1/PDL1 agents. Showed adoption - 0.4% to 48% in 2y for 2nd-line Rx #PMWC17
11:23am January 24th 2017 via Hootsuite
Gross: Other guiding principles: using science to guide; questions w/clinical relevance; team emphasizing common goals #PMWC17
11:19am January 24th 2017 via Hootsuite
Gross: Yale sharing data with Flatiron Health first had a guiding principle: putting patients first; it is a stewardship role #PMWC17
11:18am January 24th 2017 via Hootsuite
Cary Gross (Yale SOM) Early insights from an Academic-Industry collaboration #PMWC17 Unusual - in that it is a data-sharing collaboration
11:17am January 24th 2017 via Hootsuite
Abernethy: Able to overlay Overall Survival (OS) compared to TCGA datasets and their similarity. #PMWC17
11:16am January 24th 2017 via Hootsuite
Abernethy: Via FMI datashet with Flatiron - shows comparative data to TCGA dataset, able to follow it across time #PMWC17
11:15am January 24th 2017 via Hootsuite
Abernethy: Shows metrics around quality of their data curation; 1.5M+ records, always on. TCGA ref: https://t.co/ze44Xj0q4s #PMWC17
Abernethy: Essentially, high efficiency chart abstraction, highly parallelized by pathology, radiology, physician notes... #PMWC17
11:10am January 24th 2017 via Hootsuite
Abernethy: And shows a scan of a KRAS report, how it needs a human to boil that down. Interpretation at scale as structured data #PMWC17
11:09am January 24th 2017 via Hootsuite
Abernethy: Shows all the varieties of Albumin data - dozens of codes, descriptions, etc from sources boiled down to 1 record #PMWC17
Abernethy: EHR unstructured data: physician notes (PDFs), radiology reports, path, discharge notes, even condolence cards #PMWC17
11:08am January 24th 2017 via Hootsuite
Abernethy: Look at EHR structured data: demographic, Dx, visits, labs, e-Rx. Often missing NGS data/reports. #PMWC17
11:07am January 24th 2017 via Hootsuite
Abernethy: In the US: 258 cancer clinics, 2,4K cliniciants, 1.5M active cancer pts in network, aggregating EHR into 1 repository #PMWC17
11:06am January 24th 2017 via Hootsuite
Abernethy: Underlying the EMR, complex datasets. From demographics, metastatic sites, to diagnostic test results, etc etc #PMWC17
11:05am January 24th 2017 via Hootsuite
Abernethy: Thus from EMR's: aggregation, organization, completeness, quality/reliability, timeliness, access/security #PMWC17
11:04am January 24th 2017 via Hootsuite
Amy Abernethy (Flatiron Health) Unlocking real-world data. Outside of clinical trial data. 96% pts don't touch a clin trial #PMWC17
Simon: A reporter asks, 'what can you do in 9 mos?' 9 months can be half of someon'es life. #PMWC17
10:58am January 24th 2017 via Hootsuite
Simon: The Whitehouse Moonshot website 'is gone'. The effort lives on. https://t.co/CwyHv5TeMj #PMWC17
10:57am January 24th 2017 via Hootsuite
Simon: "It is why things change so slowly. Sharing data means something can happen. Hoarding data means nothing happens" #PMWC17
10:56am January 24th 2017 via Hootsuite
Simon: We need to change how we spend our money, most important: DATA. What happens to our data. Called the 'insider trading model' #PMWC17
10:55am January 24th 2017 via Hootsuite
Simon: Points to https://t.co/cN2BxtUsaT - there are >70 organizations carrying this work on #PMWC17
Simon: Howard Univ workshops, tying in another 2K participates remotely. 'a movement'. Moonshot had a 1y charter... $1.8B Cures Act #PMWC17
10:53am January 24th 2017 via Hootsuite
Simon: "You would not believe how many do not participate in clinical trials" due to practical transport, childcare, other concerns #PMWC17
10:52am January 24th 2017 via Hootsuite
Simon: Now just about every child is enrolled in a clinical trial. For cancer, a clinical trial is seen as a last-resort treatment. #PMWC17
Simon: Changing clinical trials: unethical to say 'enroll in this trial, it might help you'. It had to be altruistic before #PMWC17
10:51am January 24th 2017 via Hootsuite
Simon: Insurance and location determine cancer survivorship (!) more than any other variable - even family history #PMWC17
10:50am January 24th 2017 via Hootsuite
Simon: If you have Lynch - colonoscopy in your 20's, not 50's. 'Where you live determines how well you live w/cancer' #PMWC17
10:49am January 24th 2017 via Hootsuite
Simon: Lynch syndrome that goes undiagnosed: part of blue-ribbon panel, now screening 1st-degree relatives. Can save 1000's of lives #PMWC17
Simon: Early stage detection of cancer via blood testing: FDA wanted an atlas. 20 groups DOE, DOD, NCI, all working on this (ctDNA) #PMWC17
10:48am January 24th 2017 via Hootsuite
Simon: Deputy dir of VA: This is the most positive thing ever for the Dept of the VA (!) PMWC17
10:47am January 24th 2017 via Hootsuite
Simon: Walter Reed and VA for cancer NGS - another connection described. IBM Watson brought in 'for free' - brought all 3 together #PMWC17
