Improving cancer clinical trial accrual in Ontario, Canada: The clinical trials infrastructure fund (CTIF) experience.
Bibliographic record
Abstract
6602 Background: Participation in clinical trials is essential to evaluating safety and efficacy of emerging cancer therapies. To improve trial activities in the province of Ontario, Canada, the CTIF was established in 2002 and operationalized from 2004-2008 by the Ontario Cancer Research Network (OCRN), Ontario Institute for Cancer Research's (OICR) predecessor and funded by the Ontario government. The goals were to double trial recruitment from the baseline of 2001 and have self-sustaining trial units over 4 years. Methods: Beginning in 2004, the CTIF awards were issued in 3 phases – phase 1: 14 adult cancer centers, phase 2: 9 community hospitals, phase 3: 5 pediatric cancer centers. Per case funding (PCF) provided was $3300/patient; $4000/patient to community hospitals. The total program cost was $12.9 Million/3 years. Participating sites reported recruitment to academic and industry trials and shared 11% of additional industry trial funding over 5 years back to OCRN/OICR. The number of patients accrued was divided by the number of patients treated at sites to calculate the percentage of cancer patients accrued to clinical trials. Results: Trial recruitment and personnel increased during the years of the CTIF peaking in 2007. Trial increase was most marked for larger adult cancer centers. Successful sites maintained an average of 40% industry trials within their clinical trials portfolio and had a clinical trials manager with business experience. Conclusions: Providing additional PCF improved clinical trials accrual in Ontario, particularly in larger cancer centers that could rapidly expand their trial activities and personnel, but the effect was not sustained. Defining the best business model(s) and trial portfolio for trial units requires further elucidation. Year Cancer centers Patient accrual % Change accrual from baseline %Overall accrued to trials Patient accrual % Change accrual from baseline %Overall accrued to trials Community hospitals Baseline 2797 N/A 173 N/A 2004 4126 48 9 2005 4948 77 11 - 2006 5167 85 12 161 -7 N/A 2007 5572 100 13 187 8 4 2008 4428 58 9 76 -56 2 2009 4321 54 8 190 10 4 2010 3757 34 7 83 -52 2
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.056 | 0.065 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.005 | 0.004 |
| Scholarly communication | 0.006 | 0.002 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".