Inclusion for All: Rethinking Success, Neurodiversity, and Accessibility in the Workplace

Transcript

Inclusion for All: Rethinking Success, Neurodiversity, and Accessibility in the Workplace

[00:00:00] Alexander: You are listening to the Effective Statistician podcast. The weekly podcast with Alexander Schacht and Benjamin Piske designed to help you reach your potential lead great science and serve patients while having a great [00:00:15] work life balance.

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[00:01:30] Alexander: Welcome to another episode of The Effective Statistician. Today I am super excited to have Ana on the call. Anna, how are you doing? 

[00:01:39] Anna: I’m great. Thank you very much. 

[00:01:41] Alexander: Would you mind introducing yourself and what you [00:01:45] have been doing from a business perspective up to now working at your new company?

[00:01:52] Anna: Thank you for this opportunity. It’s amazing. So I’m Anna Forsyth. I’m a pharmacologist and a healthcare [00:02:00] economist. I’ve spent my life mostly working for pharmaceutical industry for 25 years. Years ago, I. Almost 10. I started my own company as a health economic consultancy. Fast forward to today, I did sell that company back in [00:02:15] 2020 and was planning to retire last year, but that didn’t work very well for me because I’ve realized.

[00:02:23] Anna: Very quickly that I have a skill and it’s mainly looking for the information and summarizing [00:02:30] that information or what we call in our world, conducting systematic literature reviews, and I know how to do that. I had an idea that we could automate most of the steps, not all of it, but [00:02:45] most of the steps of that and offer such a resource.

[00:02:49] Anna: Like a library of SLR pre conducted to healthcare professionals so that they could save their time searching for the [00:03:00] information. And I call that company on call scope and we started last year in February, so 2024, and we’ve just launched our beta version actually a little over a week ago. So [00:03:15] that’s where we are.

[00:03:16] Alexander: That’s awesome. And it’s the second half of March as we are recording this, so congratulations to this. How did you come across the idea of your business? Can you talk a little bit more about it and [00:03:30] where did it come from? 

[00:03:31] Anna: I have been conducting systematic web reviews my whole life and in the previous company that I had, we’ve created, I’ve realized that there is a need.

[00:03:42] Anna: For to be more up to date. We [00:03:45] all know that my clients pharma, there’s always a need and always this planning, something can fall through the cracks. And then when you’re doing a global launch as a pharma company, you may have forgotten that. And then France is launching [00:04:00] tomorrow. And where is that? SLR.

[00:04:01] Anna: This was free AI universe, so I didn’t think of ai, but what I thought of that the reporting of the SLR takes. Enormous time. Just the rep, just that [00:04:15] writing that word report and Excel report, making it all clean and tables and references. So what we did in my previous companies, we created a platform that you could load in your Excel and then you could select new.

[00:04:29] Anna: [00:04:30] Parameters, new comparators, let’s say, or outcome variables. If your SLR was very big and comprehensive and with just few buttons, you could create a regulatory level SLR report and it’s time [00:04:45] formatting a stupid task, and there’s no ai. It’s just simple Python program and we’ve created that and a lot of our clients loved it.

[00:04:55] Anna: Now that I’m on my own, I’m realizing that the same type of [00:05:00] information could be really helpful to healthcare professionals, to doctors, to guideline organizations because they had that SLR. And now that we have ai, and I met some friends on the way that [00:05:15] are really into AI and the models in ai. We are way beyond just large language models.

[00:05:22] Anna: There’s so many differences, and with the reason this iGen, when you have an agent who can read the protocol and [00:05:30] apply a different model, this is super cool what we have right now, we can actually automate the tasks of actually conducting an SLR review. As long as you standardize your outputs, you really have to standardize [00:05:45] what you’re talking about, and that is.

[00:05:47] Anna: One of the reason I’m working in cancer, the other reason it’s just personal. I have quite a few friends that have cancer, and the last reason is I have a lot of experience in cancer. And in cancer. The endpoints are, [00:06:00] as we all know, who work in, in analysis of the, the endpoints are standardized survival progression.

[00:06:07] Anna: You have response. They’re more or less standardized, and so I believe that it would be actually easier to train the [00:06:15] ai. On that, and that was the idea. Can we automate it to not 100%, because actually even at this point, I do not think 100% is possible because the human is [00:06:30] important and we are talking about life and death.

[00:06:32] Anna: We do not want to give, even if your mistake level is 1%, that’s too high, we don’t wanna give that 1%. So we do have PhDs reviewing, but. [00:06:45] QC takes a lot less time than act extraction with this and automating many silly tasks. You actual running the protocol that you have written. That simple things could be automated, not necessary [00:07:00] ai.

[00:07:00] Anna: And with automation you could cut the time so much to minutes versus weeks, and then you can also update something. Takes less than setting [00:07:15] it up. So we’ve decided we’re going to put the resources and create a library in ology. There’s 68 in NCCN guideline, and that’s the goal. 

[00:07:26] Alexander: Okay, so your goal is basically for each of these [00:07:30] oncology guidelines, you would have one SLR that is updated on an ongoing basis.

[00:07:36] Alexander: So you basically have for each protocol that is aligned with the guidelines that you wanna inform? 

[00:07:43] Anna: Yes. So far we’re [00:07:45] collaborating with asco, American Society Clinical Oncology, and they reviewed our protocol for breast and lung. Those are the first two. Tumor types we release and the next two will be prostate and colorectal.

[00:07:58] Anna: Because ASCO said these are the [00:08:00] big four and we’d like to go to the big four. So that’s where we, when we are collaborating with them, because they are testing whether they could use it for their guidelines right now. And in order to do that, we have to be in line with [00:08:15] them. 

[00:08:15] Alexander: Yeah, so that’s awesome. So you get the SLR from it.

[00:08:20] Alexander: You mentioned that doctors can then use it as well. So what will the doctors see? Will they see the systematic literature review? 

[00:08:29] Anna: So [00:08:30] the doctors are not necessarily interested in systematic viewing. The way that we need is they need to answer a question. Patient in front of you and the patient has a HER two [00:08:45] negative breast cancer stage four that metastasized and that patient has been on palbociclib.

[00:08:52] Anna: It’s a CDK 46 inhibitor for the last four years, and today I. You have that patient on the appointment and you just [00:09:00] reviewing the patient’s recent scan and the patient has a spot on the liver. That means the patient progressed while on palbociclib. So now you need to know what are you going to prescribe to that patient.

[00:09:11] Anna: Now, this is a very new area. The CDK [00:09:15] four six inhibitors were approved 10 years ago. They changed the world where patients do not progress for years sometimes. But now a lot of patients are reaching this mark, and if you open the guideline, there’s very, even if you [00:09:30] do find it on page 200 something in the NCCN guideline, and you have the patients to get to page 200 and something in a PDF.

[00:09:38] Anna: The information is quite limited. It says basically clinical trials or chemo, however. If you conduct [00:09:45] a systematic literature review, you’ll find out that was a recent RCT conducted with a positive result that continuing a CDK 46 versus switching to chemo or to hormonal therapy is statistically [00:10:00] significantly bettered PFS and Os.

[00:10:02] Anna: So why wouldn’t you offer, offer such an information to the doctor to be able to know this is beyond the guideline? Then on top of it, in January, there was a new A [00:10:15] DC approved specifically for that population. It’s in the MCCN, not yet in asco. Okay. So there’s this lag, and for doctors to be able to have access, I’m talking three clicks.

[00:10:29] Anna: They pick [00:10:30] metastatic, they pick her two negative. Then they’re looking at the new treatments, and then they could pick second line after CDK four, six. That’s a third link. They could see all the new trials. They can order them to see the most recent trial, and they don’t have to, [00:10:45] they have links to all original publications, but often, unfortunately, they don’t have time to read.

[00:10:50] Anna: So they could just click on PF, S and CPFS Os and COS. So they, we’ve extracted 32 variables from each publication. [00:11:00] They are standardized variables. This is not a custom. But in about less than a minute, they could see what they’re looking for. That just saves them time. I have talked to quite a [00:11:15] few doctors specifically for the cancers that we’ve launched, and I am still talking.

[00:11:21] Anna: I keep talking to them to understand the type of questions they want to know. I talked to a breast surgeon who wants [00:11:30] to know, he heard. At the conference that ADCs are now approved for adjuvant therapy, he needs to know in 30 seconds what type of patients are these that ADC and what’s the data looks like for ADCs.

[00:11:44] Anna: He wants to [00:11:45] know when he should consider a DC as adjuvant versus chemo. Okay. He can answer those questions very quickly and that was the point of my whole company. 

[00:11:56] Alexander: That sounds really fantastic and is really very much [00:12:00] in line with. What I wanna envision with my company as well to provide data to physicians and patients in the forms that they can understand and work with it and make the best decisions for [00:12:15] patients.

[00:12:15] Alexander: And I think there’s this huge problem that there’s out there, there’s so much information that sends a curation of this information that is so difficult. And as you just mentioned, doing an SLR is really tedious. [00:12:30] And of course it’s outdated by the time you publish it and therefore having all the time something, something that is up to date is really valuable.

[00:12:40] Alexander: Do you also plan to synthesize the data? [00:12:45] So in terms of doing meta-analysis and these kind of things within your platform? 

[00:12:50] Anna: Uh, not this year because we are a very small company and we just launched and as a matter of fact, we only. Doing solid tumors this year [00:13:00] because hematology brings out new endpoints.

[00:13:02] Anna: As you may know, in the future, I believe it is important to be able to offer a meta-analysis as an add-on. I. In my previous life, we had a live SLR and [00:13:15] live NMA, and I believe the biggest problem of all the tools, there’s many tools out there that conduct NMA on a spot. The biggest problem of these tools is garbage in, garbage out, and some.

[00:13:27] Anna: Times people end up comparing things that [00:13:30] are not comparable at all. I used to say you are comparable, not apples to apples and not even apples to oranges. You are comparing apples to rabbits. I do not know at this point whether physicians themselves [00:13:45] would be interested if impact. We going to see that.

[00:13:50] Anna: Other type of healthcare professionals, universities are using that for research purposes. They may need that, and [00:14:00] then we will add the tool. But I’m hesitant because neither the guideline organizations that I’ve discussed with nor the physicians we’re interested in analysis, which is very. Interesting.

[00:14:14] Anna: But [00:14:15] I think because they’re afraid on how you are selecting the studies, so we need to be extremely careful about that. But I would love to work with you on that when we get to that point. 

[00:14:28] Alexander: That that sounds [00:14:30] awesome. Yeah. How do you see your business transforming the way cancer is treated in the future?

[00:14:37] Anna: I’m hoping that we become the Expedia of Oncology. That’s what I would like, which means everybody has [00:14:45] access. It requires no training. You answer free questions, and you have that it is a free library. I understand that there’s a lot of other tools that exist. But I am not aware [00:15:00] and I do search every day and talk to people.

[00:15:02] Anna: I’m not aware of any tool that is actually an SLR that is update daily. You unfortunately have to break through a big barrier of [00:15:15] having AI in my company title because people immediately think I am a chat GPT like tool. I have to explain the difference between a GPT type tool or chat bot, [00:15:30] which does not provide quality of the evidence, does not differentiate between a case study I.

[00:15:37] Anna: A review paper and actually even a Wikipedia page, which is embarrassing, that physician may be basing their [00:15:45] decisions on someone else’s opinion or study and treating it equally to a well conducted RCT. But I do hope the first 10 days were the most amazing. I already have. [00:16:00] Physicians contacting me and asking me whether I’m interested in making this resource available as a library resource to the large institutions.

[00:16:09] Anna: They’re working, and because I am offering it for free, I’d like to point that [00:16:15] out to all verified healthcare professionals, which means all healthcare professionals that are involved in patient treatment. It is an altruistic goal for me. I’m offering it for free because I do want to [00:16:30] change, and I hope that it helps at least the few patients, physicians, and their interest in using a tool or staying up to date.

[00:16:40] Anna: But considering 45,000 people are expected to attend [00:16:45] ASCO, and they all paid money to go to ASCO to stay up to date, if they use the tool. That would be amazing for me. 

[00:16:53] Alexander: Yeah. I very much hope so that you get lots of attractions in terms of that because [00:17:00] I very much hope that if I, myself or family members get into the position that they have cancers, they need to under good treatment and they need to make these different [00:17:15] choices.

[00:17:15] Alexander: Let’s say have access to the most recent information and the most up-to-date information because as you mentioned earlier, it’s a life or death decision and therefore definitely helpful to have good quality data. [00:17:30] I think that’s absolutely, I. Something that we need to underline here. It’s not just the chat GPT kind of thing that puts everything under one umbrella.

[00:17:40] Anna: Exactly. And I do want to mention that we were asked already whether we are gonna have a [00:17:45] patient app. Again, I would love everything, but I’m 10 people. Okay. And I already sleep only about four hours a day at this point. So yes, we talked to several patient support organizations and we started [00:18:00] the thinking process about can we add actually a chat bot on top of.

[00:18:06] Anna: That can simplify the answers for patients where they could just simply ask question and be provided a, a more kind of a [00:18:15] simple answer because patients, it may be overwhelming for patients to answer these types of questions before they get the answer and may be more difficult to interpret because we don’t really interpret [00:18:30] the data we provide.

[00:18:31] Anna: The summary of the data in the table format, which is not really helpful to the patient. So I do have two patients sign up to the BE version and I’m looking forward to be talking to them, but we are gonna [00:18:45] be creating patient app some later this year. 

[00:18:48] Alexander: Yeah, I completely agree. Having it in the right format.

[00:18:52] Alexander: Is so key and the table that is easily interpretable by a healthcare physician is a completely [00:19:00] different story to some kind of narrative that helps people to understand these kind of different nuances. And still, of course, you need to have some kind of data literacy to understand the kind of quality of information.[00:19:15] 

[00:19:15] Alexander: And so. There will always be the need to further train, to further annotate these kind of informations. And here I’m pretty sure working with patient advocacy groups will be the way forward. 

[00:19:28] Anna: Yes, definitely. [00:19:30] We are trying to schedule that. Unfortunately, it’s the American Kidney Society that would like that the most, and I don’t have the kidney cancer, so I have to delay a little bit until I get to this indication because it’s may be different.[00:19:45] 

[00:19:45] Anna: I’m trying to basically work depending on who’s interested to work with me and what’s the demand. And so balancing the requests from the guideline organization and the requests from the patient support organizations right now. 

[00:19:58] Alexander: Yeah. How do [00:20:00] you finance your company? 

[00:20:01] Anna: As I’ve mentioned, I had a company before Purple Squirrel Economics, and I sold it in 2020, and I did make some money, so I have decided.

[00:20:12] Anna: I’m gonna invest that money to do [00:20:15] something good in the world. As a matter of fact, I did not take any investors for that, and I’m just spending my money doing that. At this point, I’m still okay and I am offering, uh, [00:20:30] subscriptions for money as of Monday when we launch people who are not verified healthcare professionals.

[00:20:37] Anna: Consultants and finance. Anybody else, if they cannot verify that they actually work in patient care, they can [00:20:45] purchase it for $59 a month. Okay. Which is still not a lot of money. Okay? But who knows? People pay for up to date this amount, okay? Maybe I get enough subscribers and I will never need investors, but at this [00:21:00] point, I delayed it till I launch, until I see the response and I do get calls.

[00:21:07] Anna: Unfortunately every day, and that’s waste my time asking me whether I’d like investors. I will take probably [00:21:15] investors later this year, but I will be very careful because I do not wanna sell my company or to sell the vision. I wanna be able to do. The altruistic work that I do, the nonprofit work, I want to make [00:21:30] sure that whoever the investor is, they understand that is the priority.

[00:21:34] Anna: And it’s not about, we don’t need to be profitable. Okay. We just need to keep being able to sustain the activity we do for the doctors [00:21:45] and other professionals. 

[00:21:46] Alexander: Thanks so much for this. Awesome. Companies that you’re starting are really a for the good of the patients. And, uh, it’s 100% aligned with my vision and my goals, and therefore, [00:22:00] I’m super happy to have you here on the podcast or see effective statistician.

[00:22:04] Alexander: Thanks so much for spending a little bit of time with me on that, and I’m pretty sure you hopefully get lots of subscriptions from statisticians. Is that [00:22:15] what I have a look into it. 

[00:22:16] Anna: Thank you very much. Thank you.

[00:22:22] Alexander: This show was created in association with PSI. Thanks to Reine and her team at VVS who helps with the show in the [00:22:30] background and thank you for listening. Reach your potential lead grade science and serve patients. Just be an effective [00:22:45] statistician.