HUNTINGTON, NY--Imagine a website designed exclusively for cancer professionals. It would, of course, offer free access to Medline via a state-of-the-art search tool, as well as access to the National Cancer Institute's PDQ database and CancerLit.
Now suppose that this website also provided a reference guide to more than 100 cancer drugs; the proceedings of the National Comprehensive Cancer Network's (NCCN) annual conference, including the NCCN practice guidelines; three full textbooks; a comprehensive, up-to-the-minute handbook on cancer management; a meetings calendar; and immediate access to the full text of more than 1,400 articles from the journal ONCOLOGY and other cancer publications--all without charge.
After almost two years in development, this website, known as the Cancer Information Network (CIN), is now a reality. The site is not only content rich but remarkably easy to use. A fast search mechanism gets the user to the desired information in only two "mouse clicks," using the system's index of cancer subjects. It also allows users to write more detailed search commands using plain English.
"The biggest complaint of physicians using the Internet has been that it takes too long to find what they're looking for, and we've eliminated that with our fast search software," John A. Gentile, Jr., president of PRR, Inc., said in an interview. PRR is one of the foremost oncology publishers and the producer of CIN.
Mr. Gentile foresaw, some two years ago, the advantage of taking PRR's publications online, but he also perceived a need for a more comprehensive, cancer-specific website that would provide the cancer professional with a form of "one-stop shopping."
Logging on to CIN gives the user access to a wide range of resources that can be searched with a single command. "And if it's not on our own website, we can link you into any other website that would be useful to the cancer specialist," Mr. Gentile said, "such as those from the pharmaceutical industry, cancer centers, or nonprofit organizations."
Resources published by PRR, Inc. and currently available on the CIN website include:
- ONCOLOGY, Oncology News International, Primary Care & Cancer, Cancer Management, and supplements to these publications.
- An expert question-and-answer feature known as Cancer Consultations.
- The diagnostic and treatment handbook Cancer Management: A Multidisciplinary Approach.
- The M.D. Anderson Cancer Center textbook Medical Oncology.
- The Industries' Coalition Against Cancer (ICAC) syllabus for establishing worksite cancer screening and education programs.
- The proceedings of the NCCN conference, including their practice guidelines and detailed flow charts.
Unlike many online databases, the documents on this new website will be offered as complete texts rather than as abstracts. Once an article is located, the physician can print it out immediately in part or in full, or save it as a file for printing out later. Physicians can also request, for a small fee, the full text of articles located through Medline or AIDSline, with items faxed within 24 hours.
The key to the ease of searching the CIN database is its intuitive navigation scheme and natural-language search system, explained Edwin S. Geffner, director of the Division of Interactive Media at PRR. "Most of the development time was spent in devising a way to let the user get the information quickly without going through multiple menus," Mr. Geffner said.
On the opening page, the CIN website provides a general index of more than 50 broad categories, including specific cancers and cancer complications.
Clicking on one of these categories immediately generates a disease-specific table of contents of all the relevant items in the PRR database, subcategorized by diagnosis, prognosis, treatment, etc. With a second click on the title of the desired document, the user instantly gets the full text of the article.
Color Shows Type of Resource
To help users quickly find the type of information they want, the items in the table of contents are tagged with color-coded icons that indicate the type of resource--news/commentary (red), review article (gold), handbook (blue), or consultation (green). The items are listed in reverse chronological order, with the most recent items listed first, and any item published within the last three months is tagged "new."
Once a document is retrieved, it can be further searched--for specific types of therapies, for example, a feature made possible by the extensive internal indexing of each article in the database.
Alternatively, the user can bypass the general index by clicking on "Search." The user then types in his search question or command, using normal conversational English. Searches can be limited to specific journals or books, or widened to include the entire CIN website.
"No other cancer website organizes information in this way," Mr. Geffner said. "You don't have to make up the terms you want to search; we provide you with the search terms already. And if you want to type in your own search category, you can do so using plain English."
In addition, without having to reformulate or retype the search command, the user can expand the search to include the entire Internet. And while searching Medline or AIDSline, if the user is not satisfied that a search has yielded sufficient information, he can go to the "Suggest" menu, which is essentially a thesaurus that provides other possible terms that might yield a more fruitful search.
When a user is interested only in a specific database or library of information, a series of buttons at the bottom of every page allows instant one-click access to the desired resource, for example, CancerLit, Medline, PDQ, the NCCN proceedings, or journals or symposia from the CIN database.
Free to Health Professionals
The CIN website is free to health-care professionals. It is being supported financially by unrestricted educational grants from pharmaceutical companies and by limited advertisements. "There will be advertising, but it will not be obtrusive. We will not overload the site with advertising," Mr. Gentile emphasized.
He also noted another important difference between CIN and other medical websites. The majority of medical web-sites are open to everyone and are designed primarily for patients and other nonprofessionals, while sites aimed specifically at professionals are often restricted only to physicians.
CIN, in contrast, is designed specifically for professionals and is available to all health professionals with an interest in cancer, such as physicians, nurses, physician assistants, pharmacists, hospital administrators, HMO administrators, and directors of nonprofit organizations.
There is a registration process by which the user gives his name; his DEA (Drug Enforcement Agency) number, if applicable; and year of graduation from medical or nursing school. Pharmacists and other health profesionals are asked to fax a request for access written on their facility's letterhead.
An Evolving Site
Both Mr. Gentile and Mr. Geffner stressed that CIN will be continually evolving with a constantly updated database and many new features planned for the near future. For example, by late spring of this year, CIN plans to make available online discussion groups moderated by specialists in the field. "These discussion groups will be disease and profession specific, with separate groups for physicians, nurses, etc," Mr. Geffner said.
A further innovation, due in the next month, is a personal reference page, "sort of a 'Best of the Web' area," Mr. Geffner said. This service will provide quick access to directories of personal and business phone numbers, e-mail addresses, a dictionary, and an encyclopedia, and areas of special interest to travelers, such as weather reports, airline and hotel reservations, and city maps.
The drug reference guide includes every antineoplastic agent available, as well as agents used for treating the complications of cancer treatment or the cancer itself, such as analgesics, antiemetics, and biologic modifiers, Mr. Geffner said. Anti-infective agents will be added in the near future.
"This guide provides the full prescribing information for each drug, but rewritten and organized in chart form to make it immediately useful to clinicians," he said.
'Tremendous Surge' Expected
Mr. Gentile believes that the Internet is going to be "a prime resource for physicians in the cancer management and treatment area." He estimates that right now there are approximately 2,500 to 3,000 physicians who use the Internet regularly to access cancer information, and he expects there will be a "tremendous surge of users in the cancer field" in the near future as Internet access becomes more widely available through such innovations as WebTV, cable modems, and more powerful home computers.
"With the introduction of the CIN website, PRR, Inc. is situated to play a vital role in meeting this informational need," Mr. Gentile said. He added that he has no fears that electronic publishing will replace written journals. "Rather, it will provide an electronic archive," he said, freeing physicians from the need to maintain old copies of journals or filed articles.