CENTERFOLD

Women's Health Study Drives Network Design

by Linda Nicastro

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W ill a low-fat diet prevent breast cancer, colorectal cancer and coronary heart disease in women? Does hormone replacement therapy prevent coronary heart disease and osteoporosis?

What is the effect of calcium and vitamin D supplements on bone fractures and certain cancers? The Women's Health Initiative, a comprehensive study funded by the National Institutes of Health (NIH), is seeking answers to questions such as these in a multicenter clinical trial that will span 15 years and involve more than 160,000 women ages 50 to 79. The Fred Hutchinson Cancer Research Center (FHCRC) in Seattle, Wash., was awarded a $143 million contract from the NIH in 1992 to serve as the clinical coordinating center for data collection, management and analysis in the Women's Health Initiative study. In return, FHCRC designed a wide area network over frame relay that joins 50 institutions nationwide using an integrated data management and computing system. The wide area network includes dozens of local area networks at clinical centers around the country--each designed with the same core information technologies. As a clinical coordinat ing center, the FHCRC serves as the information hub, overseeing the design, implementation and support of the network and ensuring the quality and usefulness of data.

Study Takes Precedence

Although there are many diverse institutions and users within the virtual community created by the network, the study takes precedence. "Unlike most business enterprises, where geographically dispersed sites reside under one corporate umbrella, we have very little authority over standards," said Scott G. Davis, network manager at FHCRC. "The study takes precedence over institutions and we developed the system in the best interests of the study. This has resulted in policy that is at odds with many different institutional standards, including those of our own." Yet, the design of the network has helped to produce productive, collaborative relationships among users. A custom-built Oracle application is used to capture, manage and report on the primary study data using replicated databases at clinical centers. Consolidated data is stored at the FHCRC. Clinical sites are equipped with turn-key local area networks that include servers running NetWare v3.12, replicated Oracle databases, Intel 486 PCs and peripherals. The FHCRC maintains frame relay circuits to clinical centers, the NIH and subcontractors. The FHCRC also handles centralized functions such as database updates, network administration and support, e-mail, backup, and data reporting and analysis.

The Women's Health Initiative is seeking post menopausal women for its study. In time, the organization's critical work may lead to answers--answers that will find solutions to alarming facts that one in eight women will develop breast cancer, that bone fractures will debilitate millions of women and that heart disease continues to be the number one killer of women.

Linda Nicastro can be reached at lnicastro@nwc.com. You can also e-mail Linda directly .

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