MOSCOW, November 18. / TASS /. Skolkovo Foundation resident UNIM (UNIM) and AstraZenec (AstraZeneca) have launched a non-profit project to standardize directions for diagnostics and diagnostic conclusions for oncological diseases, which will reduce the time of diagnosis and increase the effectiveness of therapy. This was announced to TASS by the general director of UNIM, Alexey Remez.
"The PatShablon project is aimed at introducing standards for the design of pathomorphological directions and conclusions into the work of doctors. Situations when doctors of different specializations experience communication difficulties are quite frequent in medical practice. For example, a doctor who conducts diagnostics, writes a conclusion, and directs his oncologist so that he can prescribe treatment. At the same time, the oncologist does not understand the characteristics that are indicated there, or he needs other data. As a result, he cannot prescribe an effective therapy. And this is a colossal problem, in this area there is a huge reserve of efficiency of the health care system That is, the system can work an order of magnitude more efficiently only by correcting communication between doctors, "Remez said.
In Russia, there are no uniform standards for issuing conclusions on cancer. However, solving the problem at the legislative level, according to the head of UNIM, is pointless, since medicine is developing faster than the development and implementation of initiatives at the level of, for example, the Ministry of Health or other regulators. Therefore, world practice shows that such implementation of standards occurs at the level of recommendations of professional associations or individual medical organizations.
Not only doctors, but also pharmaceutical companies are actively interested in the development of such standard templates. Thus, the diagnosis of oncological diseases should be carried out not only in a timely manner, but also accurately, otherwise modern drugs, for example, targeted or immunotherapy, will not be effective even with an insignificant error in the diagnosis.
"In fact, conclusions and directions are a single system of language. If it does not exist, then the attending physician and the doctor who makes the diagnosis simply do not understand each other. And what effective treatment can we talk about in this case? This problem does not exist. only in Russia, but in Russia it is now more acute than in other countries, for example, the USA and Great Britain, where similar standards are being introduced at the level of professional associations of doctors, "Remez explained.
Templates for effective treatment
According to Aleksey Remez, work on templates for standard directions and conclusions at UNIM began about two years ago. The systems of protocols existing in the world, including the American Association of Pathologists, the protocols of the Royal College of Pathologists of Great Britain, were taken as a basis, and the recommendations of professional associations from Japan and Australia were used for individual diseases.
“We brought together all the existing standards in the world and adapted them to Russian realities. Then we validated them with diagnostic doctors working in Russian hospitals. Because, firstly, there are still different approaches to diagnostics, there are slightly different schools, otherwise there would be no different systems and different associations. And they also validated templates with clinicians, that is, with doctors who are directly involved in treating patients, "explained the head of UNIM.
Within the framework of a joint project with AstrZeneca, doctors from N.N. N.N. Blokhin, Fomin's network of clinics, K + 31 clinic, "Clinical Hospital 1" of the Administrative Department of the President of the Russian Federation, as well as colleagues from Italy. As a result, templates of referrals and conclusions on five nosologies of the female reproductive system - for diagnoses of cancer of the body of the uterus, breast, ovaries, etc.
Any doctor, pathologist or oncologist can download them and draw up a conclusion, that is, to issue a diagnosis, as fully as possible, with parameters that are important for the oncologist and further prescription of treatment. The pathologist only needs to print two sheets and put down ticks or numbers in the required columns, fill out the patient's data by hand or on a computer. As a result, as the authors of the project expect, this will increase the speed of making conclusions, the quality of the description of the diagnosis, as well as the accuracy of the treatment, and at the same time reduce the duration of the diagnosis in general.
As Alexey Remez explained, doctors can actively participate in the project by sending their suggestions or leaving comments in a special form on the website. "There is a good rule in medicine: if the results of a diagnostic study do not change the tactics of treatment, then these studies do not need to be done. We adhere to the same position - if the proposed changes in the templates are necessary to make the treatment more effective, then, of course, we will make them. and we will be very happy for such feedback, "he added.
Prospects of the project
Further filling of "PatShalon", as explained by Aleksey Remez, will depend on the pool of experts and project partners. "I admit that we will go towards rare groups of diseases, such as neuroendocrine tumors. Or, perhaps, we will go towards the gastrointestinal tract (GIT), since gastrointestinal diseases are the most common group. We have a huge field for work, and at some point we plan to cover everything, "explained the head of UNIM.
At the same time, according to him, the project will develop not only by increasing the number of protocols. One of the main tasks that faces today is to popularize the use of templates among doctors: so that clinicians require diagnosticians to report in a standardized form, and diagnosticians receive referrals from clinicians in a standardized form.
“Professional issues of the medical community are not something that can be dismissed by directives. You cannot issue an order and say:“now do everything like this.”This does not work anywhere in the world, including in Russia, despite the vertically oriented healthcare system in our country. Of course, we will interact with health authorities, both federal and regional, and with professional associations, but this is work related to information, not orders, "explained Remez.
Another direction of the project's development, he said, is related to technology. UNIM plans to make a software product out of PatSheet that will be integrated with other information systems, including laboratory and medical systems, which will allow introducing a single language of communication between diagnosticians and clinicians at the technical level.
UNIM started its work in 2014. At the moment, hundreds of doctors from Russia, Asia, Western Europe and the United States use the cloud platform Digital Pathology, developed by the company. The company develops fundamentally new tools for the diagnosis of cancer. In 2018, she launched her own digital pathology laboratory UNIM and announced the development of a neural network that automatically determines the characteristics of cancer.