Brown University Library News

Guest post by:

Sanjay Mishra, MS, PhD
Research Associate, Warren Alpert Medical School
Research Program Manager, Center for Clinical Cancer Informatics and Data Science (CCIDS), Lifespan Cancer Institute, Rhode Island Hospital
Coordinator, COVID-19 and Cancer Consortium (CCC19.org)
https://vivo.brown.edu/display/smishr36

Jeremy L. Warner MD, MS, FAMIA, FASCO
Professor of Medicine
Associate Director of Data Science, Legorreta Cancer Center
Director, Brown/Lifespan Center for Clinical Cancer Informatics and Data Science (CCIDS)
Director, COVID-19 and Cancer Consortium (CCC19) Research Coordinating Center
Deputy Editor and Chief Software Architect, HemOnc.org
https://vivo.brown.edu/display/jwarne11

Why HemOnc.org?

The landscape of treatment and management of cancer has been rapidly expanding for decades. The number of anticancer drugs approved by the US Food and Drug Administration (FDA) and its global counterparts have grown exponentially in recent years. Not only have the approvals by regulators become narrow in scope, but the therapies are also widely prescribed off-label compared to what is approved. So, physicians, nurses, pharmacists, cost payers, software vendors, and patients need to timely and accurately track vast amounts of information about dosages, regimens, and toxicities. 

Recognizing this need, Peter C. Yang, MD created HemOnc.org as a collaborative wiki of chemotherapy information in November 2011. At the outset, we believed that the format of a Wiki, made popular by Wikipedia, was the perfect platform. It is relatively easy to update contents of a Wiki in real-time from virtually any computer with internet access, which lowers the barrier in open exchange of information and collaboration. Despite flexibility of content editing, Wikis retain past versions of pages, which allows for auditing, reversal of errors, and attribution of contributions. Further, Wikis are excellent in internally cross-linking pages to one another, which facilitates searching for information and navigation between pages. Most importantly, wikis are easy to set up, very low cost to maintain, and accessible to anyone anywhere in the world. The low cost obviates the need to seek advertisers, and HemOnc.org has been ad-free since inception.

Free and Open

As an Open Source knowledge base, HemOnc.org has remained committed to stay free and open to all users, regardless of nationality, with links provided for non-paywalled literature sources whenever possible. No registration is required to peruse the content.

Use and Review

Through the sustained progress of content additions over more than a decade, HemOnc.org is now the largest freely available medical wiki of interventions, regimens, and general information relevant to the fields of hematology and oncology. It is designed for easy use and intended for healthcare professionals, although the content is also of interest to patients themselves. While the site provides quick references to the primary literature and other useful resources, it should not be used as a substitute for formal medical training, may never be used as a substitute for independent clinical judgment, and offers no medical advice. Content on HemOnc.org is added by hematology & oncology professionals and undergoes continuous peer review. While any healthcare professional can freely sign up to contribute; the accuracy and completeness of content is moderated and overseen by an Editorial Board now composed of more than 50 members, the majority of which are board-certified hematologists and/or oncologists (adult and pediatric). 

Volume and Traffic

As of October 2023, the HemOnc.org wiki has 1349 content pages covering 187 disease entities under the broad umbrella of hematology/oncology, with over one million lines of content that describes 749 drug pages and 317 treatment regimen pages. Overall, there are 4713 regimens, with 6056 variants such as minor dosing differences on HemOnc.org that are supported by 7356 linked and annotated references to their respective trials. 

This has made HemOnc.org the go-to resource for medical doctors, especially trainees, and pharmacists, besides nurses, researchers, and patients. The website gets about 25,000-30,000 visitors per month, half of which are returning users. Due to the open nature of the wiki, we do not and cannot track all site visits, but we know that HemOnc.org has had at least 1000 visits from each of over 71 countries, and has been accessed from more than 220 countries and territories so far. 

Clinical Resource and Knowledge Base

HemOnc.org’s mission is to become a repository of all approved systemic anticancer therapy agents and supportive medications used in the fields of hematology/oncology since their inception in the 1940s. As a compendium of all standard-of-care systemic anticancer regimens, we aggregate and provide references to primary literature, their PubMed links and direct links to abstracts and full articles. HemOnc.org provides links to existing resources such as guidelines, information about prognosis, clinical calculators, staging, and patient resources classified by cancer subtypes. Beyond providing a clinical resource, the vast content of HemOnc.org now forms the basis of a formalized ontology of anticancer drugs and regimens called HemOnc. This knowledge base has been used in multiple research projects and is available in part to anybody and in full to academic and noncommercial users.