Unlocking the Potential of Real-World Evidence to Improve Cancer Care

kentarkoff

By Ken Tarkoff

01/28/2021

Reflections On How the Ongoing Global Pandemic Will Continue to Shape the Use of Real-World Data

As we close out the first month of 2021, I find myself reflecting on 2020 and feeling inspired by what the Syapse team has been able to accomplish during a year of so many challenges and unknowns. I am incredibly proud of how we came together as an organization and remained resilient and focused on building innovative solutions, breaking down silos, and delivering insights and evidence that help improve the way our customers deliver care to cancer patients. 

Real-world evidence holds tremendous potential for improving the way cancer care is delivered. This fact is reflected in the enormous amount of recent buzz and investment in the space. Realizing the full potential of RWE to impact care, however, will require delivering on three key imperatives:

  • Ensuring that the underlying real-world data is capable of answering the questions that matter most
  • Transforming high quality data into meaningful real-world evidence
  • Using real-world evidence to drive practice change and improve patient outcomes

Ensuring that the underlying real-world data is capable of answering the questions that matter most

Real-world data is not a monolith. It reflects the care overseen by the subset of providers whose experience is captured by the data. Many real-world data companies source their data from independent oncology practices––outpatient clinics largely unconnected with other specialties or inpatient care. By contrast, our Learning Health Network™ includes many of the largest community health systems in the nation. These integrated systems are not well represented by other real-world data sources today, creating blind spots in how over 50% of the nation’s cancer patients are diagnosed, tested, and treated. Additionally, community health systems include both inpatient care and other specialties in their networks, enabling real-world data from these systems to provide insight into the comprehensive patient journey. Our partnerships with these large community health systems allow us to develop real-world evidence that reflects the care patterns occurring in this large segment of the provider market, and to go deeper and broader to answer questions that cannot be answered by other sources.

The ongoing pandemic has massively shifted practice patterns, almost overnight, as patient visits, diagnoses, surgeries, and molecular testing have declined significantly since last March. As the pandemic subsides, I expect to see a surge in patients with more advanced cancers, and of course a substantial group of patients with a history of COVID-19. Understanding how the cancer landscape is shifting within the largest provider segment will be critical for all stakeholders as they navigate the “new normal” going forward. Additionally, many studies will need to be able to take into account a patient’s history of COVID-19, including hospitalizations. We have already demonstrated our ability to leverage our data platform and research collaboration with the Food and Drug Administration (FDA) to study how active cancer or a history of cancer impacts COVID-19 outcomes. As we emerge from the pandemic, it will be equally important to reverse the equation and understand how a history of COVID-19 infection impacts current cancer patients.

Transforming high quality data into meaningful evidence

Although real-world data is our foundation, data on its own does not generate meaningful real-world evidence. Appropriate real-world data science algorithms must be used to turn data into useful information. We have heard over and over again that stakeholders that have invested in accumulating large raw real-world datasets are now drowning in data but lacking in evidence. 

At Syapse, we collaborate closely with our partners to transform high quality real-world data into meaningful real-world evidence. Through our research collaboration agreement (RCA) with the FDA, we are collaborating with FDA research scientists to develop and test the analytic methodologies needed to transform high quality data into meaningful real-world evidence. Our network partners benefit directly from this work, as these tested analytic methodologies are directly leveraged in both our self-service SaaS products and our collaborative observational research studies.

As Dr. Amy Abernethy, Principal Deputy Commissioner of the FDA, pointed out during our last Syapse Precision Medicine Council, the pandemic has helped us understand how much more work we have to do to develop the advanced real-world data science methodologies required to meet the moment. For example, the sudden shift in practice patterns creates questions of how temporality and history of disease will be accounted for in our methodological approaches. We are looking forward to continuing our collaboration with the FDA.

Using real-world evidence to drive practice change and improve patient outcomes

Ultimately, to drive change across the healthcare ecosystem, real-world evidence can not sit on the shelf. It is common to see lags between when powerful new evidence is developed and when those insights completely saturate clinical practice, creating missed opportunities for improving patient outcomes. 

Our health system partners’ primary goal in working with us is to leverage RWE to improve patient outcomes by delivering the highest quality evidence-based care and developing new evidence where current standards are insufficient. Our focus is on not only curating high quality RWD and developing meaningful RWE, but also working with providers to put those insights into practice.

Early in the course of the pandemic, our molecular testing dashboards showed real-time drops in testing rates across all indications including skin and ovarian. Together with our health systems partners, we identified the patient segments most impacted and uncovered underlying drivers of these trends. We then surfaced targeted lists of patients with whom the health systems could follow up to close these care gaps. As patients return to the clinic, these types of targeted approaches for ensuring consistent delivery of the highest possible quality of care for all patients will only grow in importance.

To wrap up, I am honored and excited to be leading the Syapse team knowing the opportunity ahead is significant. As we navigate toward the one year anniversary of moving to a fully remote workforce, I am humbled by how deeply our mission has remained embedded within our virtual walls. Our team and our partners have remained resilient and focused, because we all know that cancer patients cannot wait.