Navya’s Evidence and Experience Engines, developed in collaboration with Tata Memorial Centre, enable patients suffering from cancer to upload their reports and get a response within 24 hours. Gitika Srivastava, Founder, Navya, reveals more about the collaboration in an interaction with Sanjiv Das
Tell us more about the machine learning-based system developed in collaboration with Tata Memorial Centre.
There are two components to this system. One is called the Evidence Engine, in which we create highly structured databases of high quality and published clinical trial data (called evidence) and then we match a given patient’s case details to this evidence base and use cancer informatics to determine which evidence-based treatment plan is most uniquely applicable to a given patient given demographic, tumour type, and other very minute and specific criteria. This was validated at Tata Memorial Centre to show that 98 per cent of the treatments recommended by Navya were concordant with the treatments recommended by TMC multi-disciplinary tumour board experts. These results were also validated at UCLA-Olive View Medical Centre and presented at international conferences such as San Antonio Breast Cancer Conference and American Society of Clinical Oncology.
The other component is called Experience Engine. In this, the multi-disciplinary tumour board decisions of cancer experts are captured and structured as a new source of information to make expert treatment decisions. There are many nuances in a patient’s case for which the experience of cancer experts is necessary. Such as making dose modifications for older patients or specific combinations of therapies when there are coexisting morbidities or toxicities to prior treatments. Using machine learning to learn from an expert’s treatment decision, we can predict what the recommended treatment plan would be for similar patients. This way we can scale an expert’s decision making across the globe. Padmasree Dr Rajendra Badwe is a world-renowned breast cancer expert. He cannot physically see every single breast cancer patient in the country. However, through the Experience Engine, we know with a very high degree of certainty the range of treatment options that Dr Badwe would pick for a given cancer patient. This can aid the decision making of the treating oncologists and patients nationwide.
What is the rationale behind the collaboration?
Tata Memorial Centre is one of the largest expert cancer centers in the world. It is regarded as a highly reputable centre for evidence-based practice of medicine and the oncologists at the centre see tens of thousands of highly complex cancer cases in a year. Their experience is next to none and oncologists nationwide collaborate with their specialist colleagues at TMC and other expert cancer centres such as AIIMS, Adyar, Max, etc., part of the National Cancer Grid, housed at TMC. There are over three million cancer patients in the country and the number of cancer experts treating a specific type of cancer with a given treatment modality, are likely in the hundreds. These experts have limited availability at the tertiary cancer centres for every cancer patient to benefit. However, once the treatment plan is known, patients can receive the treatment under the guidance of local treating oncologists anywhere in the country. They need not travel to the expert centres just to learn of the expert treatment plan or second opinion. Also, if the treating oncologist wants to collaboratively consult a specialist at a tertiary referral cancer center, a system such as Navya can enable that.
First, Navya can quickly summarise a patient’s case and propose relevant evidence and experience-based treatment options (from the Evidence and Experience Engine, see above). Next, the case and treatment options is sent for a multi-disciplinary review and collaboration between the cancer experts and treating oncologists. Then, a consensus opinion is generated and presented to the patient and the treating oncologist in simple laymen terms that the patient can also understand the rationale and information behind his or her cancer treatment. This enables better adherence and compliance of the patient, local care at the treating cancer centre, and improved outcomes as a result of standardised evidence-based expert recommended treatment plans. Therefore, a collaboration among Tata Memorial Centre, National Cancer Grid, and Navya in concert with the ecosystem of local care among treating cancer centres/oncologists and patients/caregivers enables an end to end solution for all stakeholders in cancer care.
How are you utilising the data that will be generated eventually?
Navya is a constantly learning system. We learn from the latest cancer research that is published on a monthly basis, and we use that to predict an evidence-based treatment for a patient. Next, we learn from every expert treatment decision so we can learn from how experts at tertiary centres decide on treatment plans for patients. And finally, when we utilise the Evidence and Experience Engine to predict a treatment decision for a patent and propose that to an expert for live expert review, we learn from the treatment choice that an expert makes and the additional tweaks that he or she adds to our recommendation to incorporate on future such decision making for similar patients. This data can help us learn about expert treatment decision making and patient outcomes when patients receive those treatments.
How is Navya going to revolutionise cancer care in the country?
Navya will ensure that every treatment decision for every cancer patient is based on evidence-based literature and experience of leading experts treating thousands of similar or complex cases and also ensure that every treatment decision receives a multi-disciplinary tumour board decision based on the evidence and experience based treatment options. In this way, every cancer patient’s care is guided optimally and there is no under treatment or over treatment or missed opportunities in care. This will enable improved patient outcomes of cure, longevity, and quality of life for all cancer patients in India. Navya will ensure that there is no disparity of access to expertise by leveraging its online platform and technology-driven patient service to deliver highly empathetic expert opinions to every patient at the lowest possible cost. No cancer patient will receive care that is not driven by published medical evidence and expertise of a multidisciplinary tumour board. This is the only way to improve cancer outcomes, and Navya will revolutionise cancer care in this way.
Are there plans to tie-up with other cancer institutes across the country?
Navya is partnering with every major cancer centre to enable expert treatment decisions that are evidence based and experience guided and ensures that this information is relayed in extremely simple terms to patients. Navya is also partnering with treating centres across the country, small and large, so that every treatment decision at those centers are guided by the expert opinions. Finally, Navya values treating oncologists and caregivers as the ultimate influence on a patient’ care. Therefore, partnering with treatment centres and patient advocates/social workers at these cancer centres, Navya ensures that every patient has access to expertise in the country.
Tell us about your expansion plans. What type of investments are you looking for in the next five years?
Navya will expand to empower every centre that excels in cancer research or cancer treatment delivery. This is the only way to bridge access from expert hubs to every spoke that touches a patient. Navya is also expanding its reach to other neighbouring countries at which the expertise of centers such as TMC and NCG can empower patients. These countries include the Middle East and South East Asian countries. Navya is looking for investment to further lower its cost of service by leveraging technology, process, and people so that each expert opinion is available to every cancer patient at the cost of ` 1500. We are looking for investments from likeminded investors who support the vision of equitable access to cancer care for every patient in India and will invest in technology and processes to enable compassionate, data driven, care at the lowest possible cost.