Is There A Strategy To Increase Accrual?

Tracking Down the Potential Patient

• Hospital Admissions

• Type of cancer cases.

• Which doctors admitted them.

• Who referred them to the admitting doctor.

• From where were they referred.

Tracking Down the Potential Patient

• Physician Offices (more difficult to do)

• Type of cases seen

• What are their referral patterns

Tracking Down the Potential Patient

• Public Health services

• Demographics

• Health services available

• Clinics and Nursing

How does a patient get on a protocol?

• Some • Symptoms-> Action -> No

• ->MD Dx ->Rx or Refer ->

• Specialist• • Protocol • ->Treatment.

Physician or Specialist

• PERSONAL meeting

• CME lectures

• Economic stake

• Personnel support

• Money/patient

Physician or Specialist

• Prestige

• Highlight involvement

• Part of decision making

• Follow the patients

• Hotline for help or complaints

Physician or Specialist

• Do not forget:

• Radiologist

• Pathologist

• Surgeon and others

Patient Environment

• Family Church

• Neighbors Community Center

Education level Social Worker

Economic status Transportation

• NIH Research:– “Southern Research” Reputation

Presentations to the general public

• Community Centers

• Churches

• Schools

• Workplaces

• American Cancer Society

Presentations to the general public

• Advertising

• Local new papers

• Marketing

• Public Relations

• Radio and T.V. interviews

Pitfalls of Community Medical Research

• Research Generates • Institutional Review Board • Protocol Monitoring• Data Safety and Monitoring• Need for medical and administrative

expertise• RTOG• Paperwork• Deviation from normal procedures

Pitfalls of Community Medical Research

• Physician Apathy

• May loose control of decision making

• Different from what they do

• Time consuming

Pitfalls of Community Medical Research

• Hospital Administration

• No experience with Fed. Grants

• No compliance expertise