Is There A Strategy To Increase Accrual?

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Is There A Strategy To Increase Accrual?
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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.

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Tracking Down the Potential Patient

• Physician Offices (more difficult to do)
• Type of cases seen
• What are their referral patterns

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Tracking Down the Potential Patient

• Public Health services
• Demographics
• Health services available
• Clinics and Nursing

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How does a patient get on a protocol?

• Some
• Symptoms-gt Action -gt No
• -gtMD Dx -gtRx or Refer -gt
• Specialist
• Protocol
• -gtTreatment.

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Physician or Specialist

• PERSONAL meeting
• CME lectures
• Economic stake
• Personnel support
• Money/patient

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Physician or Specialist

• Prestige
• Highlight involvement
• Part of decision making
• Follow the patients
• Hotline for help or complaints

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Physician or Specialist

• Do not forget
• Radiologist
• Pathologist
• Surgeon and others

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Patient Environment

• Family Church
• Neighbors Community Center
• Education level Social Worker
• Economic status Transportation

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• NIH Research
• Southern Research Reputation

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Presentations to the general public

• Community Centers
• Churches
• Schools
• Workplaces
• American Cancer Society

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Presentations to the general public

• Advertising
• Local new papers
• Marketing
• Public Relations
• Radio and T.V. interviews

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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

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Pitfalls of Community Medical Research

• Physician Apathy
• May loose control of decision making
• Different from what they do
• Time consuming

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Pitfalls of Community Medical Research

• Hospital Administration
• No experience with Fed. Grants
• No compliance expertise