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Dr Miller: Many of us who have used them can tell which ones oncologists had a hand in developing, and maybe which ones were done elsewhere. A hand in developing, a hand in the input and language of the field, or domain experts who understand what doctors really need, what patients really need, and, more importantly, how work flows so doctors can work efficiently.Dr Yu: Cancer Lin Q traces back to the Institute of Medicine, now called the National Academy of Medicine, which held a series of workshops a few years ago about big data and what was called "rapid learning systems." The idea was, with the massive data that we will be acquiring in the decades to come, how can we learn from that data and create a system where we learn from real-world experiences, understand what is actually happening out in the field, and supplement what we learn from randomized clinical trials?What might it allow us to do that we have not been able to do with the SEER database? The SEER database was created by the National Cancer Institute (NCI).Dr Yu: First, I think that the SEER database is the gold standard, or the best source of cancer observational data. It was designed as a research tool to actually ask questions.

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Dr Miller: Maybe also verify some of those data fields, because the SEER data are curated by humans. Welcome to Medscape Oncology Insights, coming to you from the 2016 annual meeting of the American Society of Clinical Oncology (ASCO). I am Kathy Miller, professor of medicine at the Indiana University School of Medicine in Indianapolis, Indiana.The flagship initiative is probably the Cancer Lin Q™ program. We have a better understanding of what the needs are.Most people, at this point, have worked with electronic medical records (EMRs) and have had some experience and a lot of frustration with them.Dr Yu: That gets to another point, which is that data are only as good as what people enter.You can try to clean it up, but it takes a lot of human work, which is expensive and somewhat wasteful and inefficient.A typical randomized clinical trial is set up with a specific question—generally an interventional question—and the design for a statistically accurate clinical trial to answer this question definitively.When you look at big data, there is opportunity to take it from a different point of view, which is to let the data speak to us. What trends do we see that we do not understand but want to understand better?Dr Miller: We have seen that some studies have used things like the Surveillance, Epidemiology, and End Results (SEER) database.How does Cancer Lin Q compare to the SEER database?

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