PRESS RELEASE 06/05/2017

CS Pramesh
Dr CS Pramesh – Coordinator National Cancer Grid

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Expert Oncologists from Tata Memorial Centre (TMC) and National Cancer Grid (NCG) Use Navya to Provide Rapid Online Opinions to Patients across 22 Developing Countries

The results of a prospective study presented at the 2017 American Society of Clinical Oncology (ASCO) meeting demonstrates the global impact of an informatics-based scalable and low cost online service to maximize outcomes for patients in areas without ready access to expertise

CAMBRIDGE, Mass., MUMBAI, India and Chicago, Ill. – June 5, 2017: “TMC NCG Navya Online” provides multidisciplinary evidence based expert opinions within 24 hours to thousands of cancer patients in urban and non urban areas in the developing world.  A prospective study assessing the real world impact of this service concluded that patients shared the expert opinions with their treating providers and received evidence-based treatment. Expanding the service to non urban USA and the western world, can maximize cancer care outcomes, globally.

There is a scarcity of expert oncologists in the world. Patients in non urban areas have poor access to evidence-based treatment decisions and worse outcomes. In India, there are circa 1600 oncologists for 1.8 million patients and the lack of expertise translates to suboptimal and expensive treatment decisions. Navya’s informatics based expert opinion service, scalably provides multidisciplinary evidence based treatment opinions on-time, empowering every patient.

Since its creation in 2014, 10,779 patients from 22 developing countries have registered with TMC NCG Navya Online. The technology based operation with a median turnaround time of 24 hours, consists of clinical analysts who collect patient data and an informatics system that generates patient-specific evidence-based treatment options.  Experts take into account  patient preferences and rapidly review and vet the options within 1-2 minutes on the mobile ExpertApp.  The system generates a consensus multidisciplinary treatment decision and analysts create an expert opinion report in simple layman language which is sent to the patient online.

“The online expert opinion service is a game changer for regions where the demand for cancer expertise far outstrips supply, by democratizing access. This has enabled proliferation of standardized evidence based treatment recommendations for patients who lack the access to tertiary care centers and thereby expertise” said Dr Pramesh, Coordinator National Cancer Grid, the world’s largest consortium of 108 cancer centers in India. Dr Pramesh made an oral presentation of this abstract at ASCO on the 5th of June, 2017.

The study included 914 patients who registered with the service between July 2016 and March 2017 and were asked via phone follow up: 1. If report was shared with treating provider, 2. Final treatments received. Of the 90% of patients who responded (n=824), 72.3% [CI 3.05%] of patients shared the Expert Opinion Reports with their treating oncologists. 78% [CI 2.95%] of patients received treatments recommended by TMC NCG Navya.  Common reasons why patients received different treatments included decline in performance status after receiving the online opinion and not testing for biomarkers (Estrogen Receptor/Progesterone Receptor, etc.), likely due to lack of access to resources.

“The finding that a high proportion of the patients are sharing the reports with their treating oncologist and most proceed treatments that TMC and NCG experts would recommend,  demonstrates that the online service has wide approval both among patients as well as local physicians and oncologists” said Dr Rajendra Badwe, Director of Tata Memorial Centre, one of Asia’s largest leading tertiary care cancer centers.

Says Gitika Srivastava, Founder of Navya: “Navya’s vision is to meaningfully move the needle in the way cancer care is delivered. This study shows that the informatics based system and service is scaleable and has positively impacted patients from all over the developing world. Expanding the reach of this service can maximize outcomes for patients, especially those in non urban areas, across the world.”

National Cancer Grid (NCG), tmc.gov.in/ncg Tata Memorial Centre (TMC) tmc.gov.in

The NCG is a consortium of 108 cancer centers, with a mandate to standardize cancer care, nationally. NCG is the largest global network of cancer centers collaborating to use technology and training to bring cancer expertise to every oncologist and cancer patient in India. TMC is Asia’s largest leading tertiary care expert cancer center, seeing over 67,000 cancer patients every year. Its strength necessitates a responsibility to make its expertise available to patients across India and developing countries, especially those who reside in locations where there are no expert cancer care centers.

Navya http://www.navya.info

Navya is a clinical informatics and patient services organization with a unique understanding of cancer patients and oncologists and a core commitment to cancer care. With a proven track record of successfully implementing innovative solutions that are low cost and effective, Navya is the first to develop an end to end expert decision system for use by cancer patients and oncologists globally.  Navya’s online expert opinion service is also the first of its kind to offer evidence based opinions from world leading experts at low cost, answering every single question of the patient, within 24 hours.

Twitter: https://twitter.com/NavyaNetwork

Facebook: https://www.facebook.com/NavyaNetwork/

LinkedIn: https://www.linkedin.com/company/15236089

Contact:  Gitika Srivastava | gitika@post.harvard.edu

PRESS RELEASE

 

 

Confronted With Complex Cancer Treatment Decisions – Navya Empowers Patients With the Consensus Opinion of an Expert Panel of Multidisciplinary Oncologists

 

Navya in partnership with Tata Memorial Center (TMC) and National Cancer Grid (NCG) enables cancer patients to have their cases reviewed by a multidisciplinary panel of experts, to arrive at the best possible treatment plan. This is critically important as cancer decisions are complex and often involve several organs and types of treatments.

A woman with advanced breast cancer may need surgical removal of the breast, radiation therapy to the brain, and multiple lines of chemotherapy with side effects impacting the heart and the liver.  Therefore, it is critical that experts in each of the specialties collaborate to determine the treatment plan; from radiologists reading mammograms and brain scans to breast oncology surgeons, neuro oncology radiation experts, and medical oncology experts.

While leading medical institutes across the world consider multidisciplinary treatment planning to be the standard of care, extreme shortage of cancer experts in India means that this is not the norm. A medical oncologist may treat breast cancer (solid tumor) and Leukemia (liquid tumor), and determine the radiation dosage for treatment.

Further, choices such as chemotherapy versus surgery, aggressive therapy versus supportive care, or Hail Mary attempts with expensive targeted therapies or enrolling in clinical trials, require evidence based knowledge and experience treating thousands of complex cases.  Such nuanced decision making weighing pros and cons of each treatment path is only possible when experts collaborate on a multidisciplinary tumor board.

At world renowned cancer centers such as TMC in Mumbai or Dana Farber Cancer Institute at Harvard, all cases are reviewed by a tumor board of cancer experts who jointly arrive at a treatment decision.  By leveraging its patented technology and collaboration with the best cancer experts in the country, Navya replicates this gold standard in cancer treatment planning.

“TMC and Navya have collaborated since 2011 to develop an expert decision system that uses clinical informatics, predictive analytics and machine learning to recommend evidence and experience-based expert treatment decisions, similar to decisions made by expert tumor boards,” said Dr. Rajendra A. Badwe, Director of Tata Memorial Centre.

At multidisciplinary tumor board meetings, a pathologist, radiologist, surgeon, medical oncologist, and radiation oncologist get together in the same room to discuss each case.  Sometimes the surgeon will suggest that the tumor be shrunk through chemotherapy or radiation and then the patient get operated. At other times the radiation oncologist may determine that the tumor site is not safe to radiate. If the radiologist determines spread of cancer across organs, the medical oncologist may recommend chemotherapy alone.  Having all relevant specialists weigh in and review the case is the ideal scenario but this is unfortunately not the modus operandi in most hospitals.  This is where Navya comes in.

Mr. Shah’s father in Rajkot was diagnosed with a form of lung cancer following a routine checkup. Several tests followed and there was confusion as it could have been metastatic mesothelioma that may or may not be operable and therefore whether to proceed with surgery and radiation therapy or chemotherapy alone was unclear. They consulted oncologists in Ahmedabad, Mumbai, and also reached out to oncologist friends in the US.  The conflicting opinions meant that even though they had access to reputed oncologists, each was making a decision in a silo. In their relentless search for credible advice, they were made aware of http://www.navya.care and the fact that it offered multidisciplinary opinions. While the previous three weeks were chaotic with several view-points and a plethora of tests being recommended, the next 24 hours served to create order where there was chaos. Mr. Shah’s case was looked at by a team of experts that included the top thoracic surgeon in the country collaborating with a senior medical oncologist and radiation oncologist. The treatment path was clear and precise and helped the family move forward with confidence.

Says Mr Shah, “By the grace of God, we are not constrained by a lack of resources, and I was able to connect with several oncologists across India and the US. However, it was tough for us to assimilate the opinions and determine the one clear path to follow. We found that only Navya was able to do this and we are grateful for the clarity and thoroughness.”

To ensure that the treatment plan is comprehensive, Navya processes cases by incorporating opinions of several experts from Tata Memorial Centre and National Cancer Grid, a consortium of expert centers in India.

“Patients at small or remote centers will now have access to the world class expertise of cancer experts in India,” said Dr. C.S. Pramesh, Coordinator of the National Cancer Grid. “Treating oncologists can consult with multidisciplinary experts online in a simulated tumor board that results in expert treatment decisions for patients everywhere.”

www.navya.care leverages the power of the internet to make access to expert treatment decisions convenient, cost effective, and ubiquitous so every cancer patient receives a multidisciplinary opinion.  Patients simply upload their medical reports and decision questions and receive an expert opinion report within 24 hours.

Gitika Srivastava, Founder of Navya, says: “Most people who have had any experience with cancer know it’s not always possible to gain access to cancer experts.   Tata Memorial Centre, National Cancer Grid, and Navya are working to change this.  Every cancer patient has the right to an expert opinion.  We urge you to leverage  www.navya.care for an online opinion. You can be assured that the opinion rests on the multidisciplinary experience of world renowned cancer experts collaborating to deliver the best possible treatment plan uniquely suited to your case.”

Tata Memorial Centre (TMC) tmc.gov.in / National Cancer Grid (NCG), tmc.gov.in/ncg

TMC is Asia’s largest leading tertiary care expert cancer center, seeing over 67,000 cancer patients every year. Its strength necessitates a responsibility to make its expertise available to patients across India and developing countries, especially those who reside in locations where there are no expert cancer care centers.  The NCG is a consortium of 104 cancer centers, with a mandate to standardize cancer care, nationally. NCG is the largest global network of cancer centers collaborating to use technology and training to bring cancer expertise to every oncologist and cancer patient in India.\

Navya http://www.navya.info

Navya is a clinical informatics and patient services organization with a unique understanding of cancer patients and oncologists and a core commitment to cancer care. With a proven track record of successfully implementing innovative solutions that are low cost and effective, Navya is the first to develop technology systems specific to Indian cancer data for use by cancer patients and oncologists in India.  Contact:  Gitika Srivastava | gitika@post.harvard.edu

Twitter: https://twitter.com/NavyaCare

Facebook: https://www.facebook.com/NavyaNetwork/

LinkedIn: https://www.linkedin.com/company/15236089

 

Tata Memorial Centre (TMC) National Cancer Grid (NCG) Online – Navya Expert Opinion Service improves access to specialized expertise in pediatric oncology to patients nationwide

Since 2015, the service has recommended evidence and experience based treatment protocols for children that can give them the best possible outcomes.

MUMBAI, India – Feb. 15, 2017: In keeping with their efforts of democratising access to their significant expertise for patients across the country, Tata Memorial Centre (TMC) reviewed the impact of their online service in helping pediatric patients on the occasion of International Childhood Cancer day. TMC NCG Online – Navya Expert Opinion Service (available at www.navya.care) provides critical treatment opinions to parents and caregivers of children with cancer. The expert opinion helps them validate or discuss an evidence based change in treatment plan with their treating oncologists. For pediatric patients, choosing the right therapy vetted by an expert, can be the difference between cure and failed treatment.

“If a child is diagnosed early and treated appropriately, 80% of cases should lead to cure. However we are seeing many cases where parents are bringing children to us as a last resort after expensive and failed treatments” said Dr Shripad Banavali, Head of Department, Medical Oncology at Tata Memorial Hospital, Mumbai. “If they had reached out to us online through TMC NCG Navya and followed our opinion, the situation could have been better. We are also finding cases where aggressive chemotherapies are being prescribed that are not suitable for children. This is partially because of the absence of pediatric oncology expertise.”

Pediatric patients are treated differently with doses and regimens than adults, and there are only a limited number of cancer experts who specialize in pediatrics.  TMC NCG Online makes it possible for patients to get the advice of specialized pediatric experts at TMC while often continuing the treatment locally. In cases where expertise or treatments that are not available locally are required, patients are advised to visit accessible expert care centres, such as those in the National Cancer Grid (NCG).

“We have been able to provide appropriate treatment recommendation to many patients in small towns where access to specialized oncology centers is sparse” continued Dr Banavali.“ A lot of these families would either have to travel significant distances or worse still proceed with suboptimal treatments leading to a reduced probability of cure.”

Pediatric oncology is a specialized expertise and often unavailable everywhere. This leads to parents approaching oncologists and physicians who lack the experience and expertise needed in treating children. In many such cases, treatment plans are followed that are not beneficial and in some cases harmful to the patient.

TMC NCG Online has also received cases where parents are reaching out to validate the need for expensive therapies. In one such case of a three month old baby boy, a reputed private hospital had recommended an expensive robotic surgery. The experts at TMC clarified that conventional surgery would be sufficient and would avoid wait time and expense of robotic surgery.

Says Dr Tushar Vora, a nationally acclaimed pediatric solid tumor expert at TMC: “Pediatric malignancies have a very high cure rate but the best chance of cure is the first chance. Many a times, given the emotional state of diagnosis, families are financially exploited and given inappropriate treatment in the name of emergency, which significantly affects the ultimate cure rates. In such circumstances TMC NCG Online – Navya Expert Opinion Service can give the families the means to evidence based recommendations quickly and prevent the above.”

Continues Dr Vora; “also in circumstances when heroic efforts, again with financial and emotional appeal, are counterintuitive, the expert opinions can give realistic hopes and expectations and means for the best possible course.”

On the positive side, TMC NCG Navya has been able to empower families with expert opinions that have enabled them to change treatment plans leading to improved outcomes. A child from Delhi was being treated for Turberculosis without improvement. TMC experts suspected cancer and recommended a surgical biopsy which proved Lymphoma.  The child is currently under life saving treatment for the same.

Urging parents of pediatric cancer patients, Gitika Srivastava, Founder of Navya, shares her personal viewpoint:  “Most people who have had any experience with cancer are aware of TMC and that it is one of the largest tertiary care centres in the world. However not everyone from far flung areas in the Indian subcontinent or developing countries in Asia and Africa can come to Mumbai or is aware of the significance of a proper choice in treatment to a change in outcomes. Given the cases we have seen, we would urge everyone to get an expert opinion through TMC NCG Online. As parents, you can be assured that the opinion rests on the experience of world renowned pediatric cancer experts and follows evidence based protocols best suited to your child’s specific case.”

National Cancer Grid (NCG), tmc.gov.in/ncg Tata Memorial Centre (TMC) tmc.gov.in

The NCG is a consortium of 104 cancer centers, with a mandate to standardize cancer care, nationally. NCG is the largest global network of cancer centers collaborating to use technology and training to bring cancer expertise to every oncologist and cancer patient in India. TMC is Asia’s largest leading tertiary care expert cancer center, seeing over 67,000 cancer patients every year. Its strength necessitates a responsibility to make its expertise available to patients across India and developing countries, especially those who reside in locations where there are no expert cancer care centers.

Navya www.navya.info

Navya is a clinical informatics and patient services organization with a unique understanding of cancer patients and oncologists and a core commitment to cancer care. With a proven track record of successfully implementing innovative solutions that are low cost and effective, Navya is the first to develop technology systems specific to Indian cancer data for use by cancer patients and oncologists in India.
Contact:  Gitika Srivastava | gitika@post.harvard.edu

Twitter: https://twitter.com/NavyaNetwork

Facebook: https://www.facebook.com/NavyaNetwork/

LinkedIn: https://www.linkedin.com/company/navya-network

Tata Trusts and Tata Memorial Centre (TMC) Join Hands with the National Cancer Grid (NCG) Comprising 89 Cancer Centres to Make Cancer Expertise Accessible and Affordable to Patients Across India

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PRESS RELEASE

Tata Trusts and Tata Memorial Centre (TMC) Join Hands with the National Cancer Grid (NCG) Comprising 89 Cancer Centres to Make Cancer Expertise Accessible and Affordable to Patients Across India

In a Move to Standardize Cancer Care Nationally, Tata Trusts and TMC Bring Together Experts from NCG to Grow the Online Expert Opinion Service, Launched with Navya

CAMBRIDGE, Mass., MUMBAI, India – Dec. 20, 2016 – In keeping with their strategy of harnessing technology for social good, the Tata Trusts had supported the Navya online expert opinion service at Tata Memorial Centre last year. This service aids in standardising cancer care, by providing treatment opinions from the world’s leading experts to every cancer patient, irrespective of  their geographical location or ability to understand medical information.

“The Trusts and TMC plan to expand this service now to the National Cancer Grid”, said Mrinalini Pandit, who leads cancer projects at the Trusts, “Expert oncologists from NCG will join experts from TMC to provide evidence and experience-based opinions—online—using the Navya decision system.” (Patients visit:  navyanetwork.com/tmcncg)

TMC is one of the world’s largest tertiary care cancer centers and convenes the National Cancer Grid, a consortium of 89 cancer hospitals.  Navya is a leading clinical informatics and patient services organization in cancer decision making. Leveraging the Navya decision system and team of committed patient advocates, Tata Trusts has empowered over 5,000 cancer patients, pan-India and from over 30 developing countries in Asia and Africa, with evidence and experience-based information.

Expertise is defined as evidence and experience-based knowledge necessary to determine the individualized treatment for a cancer patient.  Expert decisions can maximize outcomes:  increase lifespan or number of cancer free years, improve quality of life, etc., no matter the stage and type of cancer.

There is a real scarcity of cancer experts in India, located mostly in metropolitan cities, but the number of cancer patients in need of an expert opinion is in the millions.  Traveling to consult an expert at each of the many treatment decision points is costly, logistically complex, and delays the onset of treatment.

Further, application of medical evidence at the point of care is difficult as there is a rapidly increasing number of clinical trials and knowing which trials will be relevant for a given patient requires a technology system and clinical informatics. Experience is trapped in the minds and practice of experts at tertiary care centers, and unlocking that learning from medical records and past treatment decisions with machine learning is critical.

“TMC and Navya have collaborated since 2011 to develop an expert decision system that uses clinical informatics, predictive analytics and machine learning to recommend evidence and experience-based expert treatment decisions, similar to decisions made by expert tumor boards,” said Dr. Rajendra A. Badwe, Director of Tata Memorial Centre. “The system has been validated in clinical trials at TMC and the University of California Olive View Medical Centre, showing 98 percent agreement between the system’s decisions and the tumor boards’ decisions.  These results have been published at the San Antonio Breast Cancer Symposium and the American Society of Clinical Oncology.  Collaboration between NCG, TMC, and Navya will be a force multiplier to extend the reach and impact of providing expert cancer care opinions throughout the country.”

“Patients at small or remote centers will now have access to the world class expertise of cancer experts in India,” said Dr. C.S. Pramesh, Coordinator of the National Cancer Grid. “Treating oncologists at non-expert centers can consult with experts online in a simulated tumor board that results in expert treatment decisions for patients everywhere. Treating oncologists or oncologists in training can learn to make expert-grade treatment decisions by using the Navya system and learning from the treatment decisions made by experts for their patients.”

Experts from TMC and NCG volunteer their expert opinion in conjunction with the Navya system to empower cancer patients and treating oncologists from northeast to urban India, from Bangladesh to Mozambique, from remote cancer centers in Bihar to large hospitals in Delhi, from Below Poverty Line (BPL) card holders to wealthy patients.

Dr. Raghunadharao Digumarti, an expert from one of the NCG centers, the Homi Bhabha Cancer Hospital & Research Center in Vishakhapatnam, is committed to using the Navya system to guide patients everywhere.  He said, “I am able to provide opinions on a daily basis, and within minutes on my mobile.  The system displays the relevant data and options to choose from, so it is easy to provide an online opinion.  It brings me great satisfaction to know that I am able to help patients with complex or advance disease, without them having to travel from Jammu or Jharkhand or Chhattisgarh, to my center in Vishakhapatnam. I hope more patients reach out to my colleagues and me at the NCG.”

To access TMC NCG Online – Navya Expert Opinion Service, patients or treating oncologists simply register at http://www.navyanetwork.com/tmcncg and upload the patient’s medical reports. A Navya patient advocate contacts them immediately. Navya’s decision system and TMC NCG experts suggest evidence and experience based treatment options.  Within 1-2 days of uploading their medical reports, patients or treating oncologists receive the expert opinion report. They administer the treatment locally, enabling standardized high quality cancer care throughout the country.

“A system and a service are essential to bring expertise to every patient – together with good hearted experts from TMC and NCG,” said Gitika Srivastava, Founder of Navya. “Our innovations in decision making enable our dedicated patient advocates to empower every cancer patient. Navya is the glue that brings all elements of expertise together –with the cancer patient at the center of our system enabled service.”

Decision making is an iterative process, and patients have many questions.  Even if expertise is accessible, it is difficult for a patient to comprehend and factor it in decision making. There is a need for an intermediary to communicate pertinent medical information to a patient in laymen’s terms.   Handholding empowers the patient with information about their cancer treatment, but requires immense dedication, patience, and hard work.

Navya’s patient advocates bridge the gap of communication between the patient and the expert.  They use the Navya system to translate a patient’s medical report and decision questions into “physician-speak”, and translate the evidence and experience-based expertise into “patient-speak” (i.e. simply reports with supporting references ).

TMC NCG Online is supported by Tata Trusts and is free for patients who are Below Poverty Line. A processing fee of Rs. 5000/- applies to other Indian patients, which is significantly lower than the costs of travel, lodging, associated with in-person consultations with experts in metropolitan cities. Most importantly, it eliminates inaccessibility to expertise in large parts of India, and uniformly brings expert care to cancer centers and patients.

About Tata Trusts  tatatrusts.org
Tata Trusts are amongst India’s oldest, non-sectarian philanthropic organisations comprising of Sir Ratan Tata & Allied Trusts (estd. 1919) and Sir Dorabji Tata & Allied Trusts (estd. 1932). The Trusts work in several areas of community development. Tata Trusts seek to be catalysts in development by supporting institutions in the areas of Natural Resources Management, Rural Livelihoods, Urban Livelihoods & Poverty, Education, Civil Society and Governance, Health and Media Arts, Crafts and Culture.

Twitter:  https://twitter.com/tatatrusts
Facebook:  https://www.facebook.com/TataTrusts/
LinkedIn: https://www.linkedin.com/company/tatatrusts

About National Cancer Grid (NCG), Tata Memorial Centre (TMC)  tmc.gov.in
The NCG is a consortium of 89 cancer centers, with a mandate to standardize cancer care, nationally. NCG is the largest global network of cancer centers collaborating to use technology and training to bring cancer expertise to every oncologist and cancer patient in India. TMC is Asia’s largest leading tertiary care expert cancer center. Its strength necessitates a responsibility to make its expertise available to patients across India and developing countries, especially those who reside in locations where there are no expert cancer care centers.

About Navya  navyanetwork.com 
Navya is a clinical informatics and patient services organization with a unique understanding of cancer patients and oncologists and a core commitment to cancer care in India. With a proven track record of successfully implementing innovative solutions that are low cost and effective, Navya is the first to develop technology systems specific to Indian cancer data for use by cancer patients and oncologists in India.

Twitter:  https://twitter.com/NavyaNetwork
Facebook:  https://www.facebook.com/NavyaNetwork/
LinkedIn:  https://www.linkedin.com/company/15236089

Tata Memorial Centre and Navya Create Experience Engine (XE) that “Thinks” like Expert Oncologists

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Press Release

Tata Memorial Centre and Navya Create Experience Engine (XE) that “Thinks” like Expert Oncologists  

System Mines Knowledge of World Leading Experts for Cancer Treatment; Promising Results Presented at San Antonio Breast Cancer Symposium (SABCS) – December 6-10, 2016 – San Antonio, TX  

CAMBRIDGE, Mass., MUMBAI, India and SAN ANTONIO, Texas Dec. 7, 2016 – Tata Memorial Centre (TMC), seeing over 50,000 new cancer patients a year, and Navya, a clinical informatics and patient services organization focused on complex decision making, announced Experience Engine (XE), a machine learning solution to structure experiential knowledge relevant for treatment decision making. The learning solution derives a similarity metric for patients who have received similar treatments and predicts treatment decisions that experts are likely to recommend. XE goes beyond evidence, solving patient cases that clinical trial data does not.

Promising results from the first trial of organized learning from past tumor board decisions at TMC and UCLA-OVMC to predict treatment decisions that oncologists would make for a new set of patients are being presented at SABCS 2016. The abstract titled, “Building an Experience Engine to Make Cancer Treatment Decisions Using Machine Learning,” is being presented on Wednesday, December 7, 2016.

Dr. Rajendra A. Badwe, Director, TMC said, “The Experience Engine captures the way experts think and outputs treatment options for each patient in line with what they would recommend. This is how we can scale access to expertise. The resulting database of opinions is also an excellent companion for online training.”

Being a tertiary care referral center, TMC’s experts treat highly complex, nuanced and rare cases from across the Indian subcontinent, Asia and Africa. Multidisciplinary tumor board decisions at TMC represent an unparalleled wealth of intelligence and experience, currently trapped in the minds of experts and electronic medical records.

Dr. Naresh Ramarajan, graduate of Harvard College and Stanford School of Medicine, and Founder and Chief Medical Officer at Navya said, “Tata Memorial Centre and Navya create a new source of knowledge. The Experience Engine has implications for training oncologists, standardizing cancer care across the world and driving accurate decisions for complex patients not addressed by the evidence.”

Navya’s Engines synthesize evidence specific to a patient and learn from relevant tumor board decisions to make treatment decisions. The Navya Evidence Engine (EE) was validated in three clinical trials at Tata Memorial Centre and UCLA-OVMC. Results showing 98 percent concordance between the EE decisions and TMC and UCLA-OVMC tumor board decisions were published at the SABCS in 2014 and American Society of Clinical Oncology (ASCO) in 2016.

Tumor boards at tertiary centers like TMC and UCLA-OVMC provide solutions to complex cases not addressed by high quality evidence. Experts intuitively retrieve patterns from years of experience to make treatment decisions. Short of personal consultations, there is no way to access this vast “experience database.”

Richness of Navya’s ontology represents each patient with 690 individual features. XE uses relevance learning to identify the core set of highly informative features for decision making.

Multiple similarity distance metrics were systematically evaluated for each decision point. When a new patient was presented to XE, the learned similarity metric was used to identify similar patients. XE then predicts a decision based on the treatment received by these similar patients.

XE’s predicted decision was compared with the expert’s actual decision. The primary endpoint of comparison was accuracy (defined as AUC – Area Under Curve). In addition, state of the art multiclass classification algorithms were also evaluated. Winning XE algorithms were chosen specific to each decision point. The algorithms were used on a completely new prospective group of patients who were seeking an online opinion from tumor board experts of Tata Memorial Centre.

Accuracy of prediction for each decision point was significantly (~40 percent) more accurate than baseline of weighted random guessing. When XE predicted whether a patient needed standard evidence based therapy or a non-standard experience based therapy, it was highly accurate (70 percent to 99 percent based on the decision point).

The XE is a truly novel source of knowledge, containing learning from patients with significant comorbidities, multiple lines of prior treatments and poor performance status for whom standard evidence-based treatments from randomized control trials are not applicable. The analysis of hundreds of similar patients to these complex patients uncovers new insights into possible treatments.

Further, XE enables oncologists to evaluate why similar patients may receive different treatments. Variations in practice patterns, treatment centers, expert preferences, affordability of patients and patient preferences, are features that influence decision making. These are considered by XE, but not possible to consider by medical evidence guided by randomized clinical trials.

About Tata Memorial Centre
Tata Memorial Centre, founded in 1941, leads the Indian subcontinent in cancer care by evidence based practice of oncology, and research and services which are affordable, innovative, and relevant to the needs of the country.   Every year nearly 50,000 new patients visit TMC from all over India and developing countries in Asia, Africa. Approximately, 70 percent of these patients are treated almost free of charge.   Visit: https://tmc.gov.in.

About Navya
In 2009, Navya was founded in Cambridge, MA by graduates of Harvard, MIT Sloan, and Stanford.  Navya’s patented system uses clinical informatics, predictive analytics and machine learning technologies. It combines several clinical information sources as inputs – and outputs a treatment decision most applicable to a unique patient.  For the first time, quick and affordable access to evidence and experience based expert treatment decisions is available to every cancer patient. Navya’s Online Expert Opinion Service has been used by 8000 patients in 42 countries. Visit: www.navyanetwork.com.

Twitter: @NavyaNetwork
Facebook: https://www.facebook.com/NavyaNetwork/
LinkedIn: https://www.linkedin.com/company/15236089

Media Contact:
Tracy Wemett
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tracy@broadpr.com

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