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



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


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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