title: Cancer clinical trial enrollment of diverse and underserved patients within an urban safety net hospital.
abstract: BACKGROUND
  Enrollment rates onto cancer clinical trials are low and reflect a small subset of the population of which even fewer participants come from populations of racial or ethnic diversity or low socioeconomic status. There is a need to increase enrollment onto cancer clinical trials with a focus on recruitment of a diverse, underrepresented patient population.
  
  
  OBJECTIVE
  To use the electronic medical record (EMR) to understand the eligibility and enrollment rates for all available cancer trials in the ambulatory care setting at an urban safety net hospital to identify specific strategies for enhanced accrual onto cancer clinical trials of diverse and underserved patients.
  
  
  METHODS
  A clinical trial screening note was created for the EMR by the clinical trials office at an urban safety net hospital. 847 cancer clinical trial screening notes were extracted from the EMR between January 1, 2010 and December 31, 2010. During that time, 99 cancer trials were registered for accrual, including clinical treatment, survey, data repository, imaging, and symptom management trials. Data on eligibility, enrollment status, and relationship to sociodemographic status were compared.
  
  
  CONCLUSIONS
  This is a single-institution and retrospective study.
  
  
  CONCLUSIONS
  The findings demonstrate that a formal process of tracking cancer clinical trial screens using an EMR can document baseline rates of institution-specific accrual patterns and identify targeted strategies for increasing cancer clinical trial enrollment among a vulnerable patient population. Offering nontreatment trials may be an important and strategic method of engaging this vulnerable population in clinical research.
authors: Section of Hematology/Oncology, Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA. naomi.ko@bmc.org.
authors: Naomi Y
authors: NY
authors: Ko
authors: Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Julie L
authors: JL
authors: Fu
authors: Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Sarah C
authors: SC
authors: Lane
authors: Section of Hematology/Oncology, Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Kathy
authors: K
authors: Finn
authors: Section of Hematology/Oncology, Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Sandy
authors: S
authors: Allten
authors: Section of Hematology/Oncology, Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Nectaria
authors: N
authors: Vassilakis
authors: Section of Hematology/Oncology, Department of Medicine, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Lisa
authors: L
authors: Stober
authors: Department of Radiation Oncology, Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Lisa
authors: L
authors: Kachnic
authors: Women's Health Unit, Boston Medical Center, Boston, Massachusetts, USA.
authors: Tracy A
authors: TA
authors: Battaglia
keywords: cancer disparities; clinical informatics; clinical trials; eligibility determination; research patient recruitment