Special Issue: Clinical Trials Enrollment
Cancer Trials Accrual Tool Focuses on Solutions
NCI researchers last month unveiled a new online tool for clinicians and professionals who recruit people to join cancer clinical trials. The tool, called AccrualNet, is both a repository of information and a forum for professionals to exchange ideas about the challenges associated with developing and managing these important studies.
AccrualNet was introduced at the Cancer Trial Accrual Symposium, held April 29–30 in Bethesda, MD. The conference, hosted by NCI and the American Society of Clinical Oncology, attracted more than 350 leaders and representatives from organizations actively engaged in clinical trial recruitment.
The meeting was dedicated to building the science behind accrual. Much has been learned in recent years about how to recruit patients to trials and support these patients while they go through treatment. But much of that information resides only in the minds of those who have conducted clinical trials, and what has been documented in the scientific literature is scattered.
A potential solution to this problem is AccrualNet. The tool aggregates knowledge about clinical trials and makes this information available to professionals in the field. The Web site features a searchable, annotated list of journal articles on clinical trial recruitment and links to relevant publications, such as a guide to informed consent and a study of attitudes toward clinical trials within the African American community.
“AccrualNet is a repository of information and resources that has never existed before,” said lead developer Dr. Holly Massett of NCI’s Office of Communications and Education. “At the same time, the tool will allow people to interact and share ideas about clinical trial accrual.”
Dr. Massett and her team began researching the project in early 2008. The goals were to understand the landscape of information on clinical trial recruitment and to identify what was missing. The researchers interviewed a variety of stakeholders and visited community oncology practices as well as NCI-designated comprehensive cancer centers.
Several themes emerged from the interviews. “People struggle to find information about clinical trial accrual,” said Dr. Massett. “Over and over again we heard people say: ‘If only the accrual resources were in one place.’ Another common refrain was: ‘I wish I could talk to other people about accrual.’”
Based on these findings, the researchers developed a prototype of AccrualNet. Information and resources were identified for each stage of a trial, from pre-study planning to the active phase and post-study evaluations. As the Web site notes, “At every stage, recruiting issues matter.”
Extensive user testing revealed a strong desire among many professionals to be able to connect with colleagues and share resources and tips. The developers created a “community of practice” that allows users to contribute materials, tips, experience, and information about best practices. Users can also offer comments on materials.
AccrualNet also allows professional groups to create a forum where they can have discussions about topics of interest on the site. For example, administrators in the Community Clinical Oncology Program have set up a group for discussions.
The project’s main goal is to increase knowledge about the processes needed for success in clinical trial accrual. Another is to encourage the use of available literature and resources in planning and conducting recruitment activities.
Beyond these immediate goals, the project could help identify gaps in the research around accrual strategies and define future research questions.
AccrualNet is designed to grow along with the science behind accrual, and it currently shares the limitations of the field. Much of the evidence consists of reports from single institutions, and there are few randomized controlled studies (considered the gold standard of evidence) on accrual and retention.
“AccrualNet is a starting point,” noted Dr. Massett. “But it has the potential to be a framework for how we look at accrual in cancer clinical trials moving forward.”
AccrualNet is just one of many projects aimed at achieving the important accrual goals that were presented during the Cancer Trial Accrual Symposium. Slides and information on some of the presentations are now available.