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The Front Line: Charles D. Blanke, MD, SWOG Chair
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Secondary Analysis Comes First in New NCORP Opportunity

Nov. 13, 2015 - "Value" is currently a big issue in oncology practice, and in medicine in general. Mighty ASCO itself is active with its initiative to define value in cancer care, and create practical tools doctors can use to gauge value and to make clinical decisions.

Value has been defined as outcome relative to costs (Porter, New Engl J Med 2010). How do we maximize value in our research? Secondary analysis has big-time potential to help.

Secondary analyses, of course, use existing research data to answer new research questions. This is smart, particularly at a time when resources for new projects are scarcer. Primary studies, as we know, are expensive and time-intensive. Secondary analyses, by contrast, usually don't require safety testing, rigid regulation reporting, or patient enrollment, care, and monitoring. They do require curious and computational minds. Thankfully, SWOG is graced with many.

Dr. Joe Unger, a statistician and health researcher at our statistical center in the Fred Hutchinson Cancer Research Center, along with Dr. Dawn Hershman, Dr. Julie Gralow, and Dr. Scott Ramsey, just published results from a high-profile secondary analysis in JAMA Oncology. The team used data from a prospective survey of barriers to participation in trials conducted in eight SWOG clinics across the U.S. Using a regression model, they looked at the association between income and trial participation for patients with lung, breast, and colorectal cancers. They found something disturbing, though perhaps not surprising. Patients with incomes of less than $50,000 a year are a lot less likely to join a trial. In fact, they take part at a rate that's 32 percent lower compared with wealthier peers. These findings highlight the impact income disparities can have on health care, and point the way toward more equitable health care policy. The findings were published last month and received a raft of media attention, including by Reuters, U.S. News and World Report, and The Washington Post.

This is a great example of a high-value, high-impact secondary study. Now, we have support for more. Thanks to Dr. Hershman and the board and staff at The Hope Foundation, SWOG researchers at NCORP sites can apply for up to $25,000 for secondary analysis projects that reduce disparities and otherwise improve cancer care and delivery. These new Hope grants are designed to give community sites the statistical expertise needed to execute complex data analyses. If you're interested, please act fast. The deadline for applications is December 1. See thehopefoundation.org/research-funding/juried-programs/ncorp-pilot-grants-program/

I thank Dr. Hershman, as well as the folks at Hope, for making these new grants possible. They're a good move at the right time. SWOG has conducted more than 1,000 trials, and collected more than 600,000 biospecimens. There's a lot of "secondary" treasure to mine.