New Website Gateway to Vast Array of Cancer Resources

HUNTINGTON, NY--Imagine a website designed exclusively for cancer professionals.It would, of course, offer free access to Medline via a state-of-the-artsearch tool, as well as access to the National Cancer Institute's PDQ databaseand CancerLit.

Now suppose that this website also provided a reference guide to morethan 100 cancer drugs; the proceedings of the National Comprehensive CancerNetwork's (NCCN) annual conference, including the NCCN practice guidelines;three full textbooks; a comprehensive, up-to-the-minute handbook on cancermanagement; a meetings calendar; and immediate access to the full textof more than 1,400 articles from the journal ONCOLOGY and other cancerpublications--all without charge.

After almost two years in development, this website, known as the CancerInformation Network (CIN), is now a reality. The site is not only contentrich but remarkably easy to use. A fast search mechanism gets the userto the desired information in only two "mouse clicks," usingthe system's index of cancer subjects. It also allows users to write moredetailed search commands using plain English.

"The biggest complaint of physicians using the Internet has beenthat it takes too long to find what they're looking for, and we've eliminatedthat with our fast search software," John A. Gentile, Jr., presidentof PRR, Inc., said in an interview. PRR is one of the foremost oncologypublishers and the producer of CIN.

Mr. Gentile foresaw, some two years ago, the advantage of taking PRR'spublications online, but he also perceived a need for a more comprehensive,cancer-specific website that would provide the cancer professional witha form of "one-stop shopping."

Logging on to CIN gives the user access to a wide range of resourcesthat can be searched with a single command. "And if it's not on ourown website, we can link you into any other website that would be usefulto the cancer specialist," Mr. Gentile said, "such as those fromthe pharmaceutical industry, cancer centers, or nonprofit organizations."

Logging on to CIN

The Cancer Information Network (CIN) website was developed for optimalviewing with Internet Explorer 3.0, software that is available free fromMicrosoft for Windows 3.1, Windows 95, and the Macintosh operating system,and is provided to users of America Online and CompuServe. However, anyframes-capable browser, such as Netscape Navigator 2.0 or 3.0, may alsobe used.

In addition to the PRR, Inc. publications and other resources, CIN providesunlimited free access to Medline, AIDSline, PDQ, and CancerLit. Professionalsmay log on at www.cancernetwork.com.

Resources published by PRR, Inc. and currently available on the CINwebsite 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 MultidisciplinaryApproach.
• The M.D. Anderson Cancer Center textbook Medical Oncology.
• The Industries' Coalition Against Cancer (ICAC) syllabus for establishingworksite cancer screening and education programs.
• The proceedings of the NCCN conference, including their practice guidelinesand detailed flow charts.

Unlike many online databases, the documents on this new website willbe offered as complete texts rather than as abstracts. Once an articleis 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 navigationscheme and natural-language search system, explained Edwin S. Geffner,director of the Division of Interactive Media at PRR. "Most of thedevelopment time was spent in devising a way to let the user get the informationquickly without going through multiple menus," Mr. Geffner said.

On the opening page, the CIN websiteprovides a general index of more than 50 broad categories, including specificcancers and cancer complications.

Clicking on one of these categories immediately generates a disease-specifictable of contents of all the relevant items in the PRR database, subcategorizedby diagnosis, prognosis, treatment, etc. With a second click on the titleof 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 itemsin the table of contents are tagged with color-coded icons that indicatethe type of resource--news/commentary (red), review article (gold), handbook(blue), or consultation (green). The items are listed in reverse chronologicalorder, with the most recent items listed first, and any item publishedwithin the last three months is tagged "new."

Once a document is retrieved, it can be further searched--for specifictypes of therapies, for example, a feature made possible by the extensiveinternal 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 specificjournals 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 tosearch; we provide you with the search terms already. And if you want totype 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 whilesearching Medline or AIDSline, if the user is not satisfied that a searchhas yielded sufficient information, he can go to the "Suggest"menu, which is essentially a thesaurus that provides other possible termsthat might yield a more fruitful search.

When a user is interested only in a specific database or library ofinformation, a series of buttons at the bottom of every page allows instantone-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 supportedfinancially by unrestricted educational grants from pharmaceutical companiesand by limited advertisements. "There will be advertising, but itwill not be obtrusive. We will not overload the site with advertising,"Mr. Gentile emphasized.

He also noted another important difference between CIN and other medicalwebsites. The majority of medical web-sites are open to everyone and aredesigned primarily for patients and other nonprofessionals, while sitesaimed specifically at professionals are often restricted only to physicians.

CIN, in contrast, is designed specifically for professionals and isavailable to all health professionals with an interest in cancer, suchas 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; hisDEA (Drug Enforcement Agency) number, if applicable; and year of graduationfrom medical or nursing school. Pharmacists and other health profesionalsare 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 continuallyevolving with a constantly updated database and many new features plannedfor the near future. For example, by late spring of this year, CIN plansto make available online discussion groups moderated by specialists inthe field. "These discussion groups will be disease and professionspecific, with separate groups for physicians, nurses, etc," Mr. Geffnersaid.

A further innovation, due in the next month, is a personal referencepage, "sort of a 'Best of the Web' area," Mr. Geffner said. Thisservice will provide quick access to directories of personal and businessphone numbers, e-mail addresses, a dictionary, and an encyclopedia, andareas of special interest to travelers, such as weather reports, airlineand 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 treatmentor 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 eachdrug, but rewritten and organized in chart form to make it immediatelyuseful to clinicians," he said.

'Tremendous Surge' Expected

Mr. Gentile believes that the Internet is going to be "a primeresource for physicians in the cancer management and treatment area."He estimates that right now there are approximately 2,500 to 3,000 physicianswho use the Internet regularly to access cancer information, and he expectsthere will be a "tremendous surge of users in the cancer field"in the near future as Internet access becomes more widely available throughsuch innovations as WebTV, cable modems, and more powerful home computers.

"With the introduction of the CIN website, PRR, Inc. is situatedto play a vital role in meeting this informational need," Mr. Gentilesaid. He added that he has no fears that electronic publishing will replacewritten journals. "Rather, it will provide an electronic archive,"he said, freeing physicians from the need to maintain old copies of journalsor filed articles.