1. DePICTRB will make retinoblastoma a
Globally,
2 in 3 children
with retinoblastoma die.
For $258 per child
DePICTRB will make retinoblastoma a
Zero Death Cancer.

2. DePICTRB Retinoblastoma (RB) is a cancer of the infant retina
8,000 RB cases annually and 70% mortality
Complex care in few centres with poor communication
No standard of care for RB, a uniquely failed evidence base
For $13.3 million USD, over 10 years, modern science and information technology will make RB the first Zero Death Cancer
How?
Deploy DePICTRB to index every RB case and enhance communication
$2.8 million to onboard 180 treatment centers
Manage + Maintain DePICTRB
$4.9 million to create and support 51,500 patient accounts
Develop RB standard of care
$5.6 million to research RB treatment approaches and create a learning health system
Beyond RB, demonstrate a novel approach to care optimization
BG KH merged

3. DePICTRB Cost (Million, USD, 0.8 CND) Years 1 - 5 Years 6 - 10 10 Year
Deploy
Personnel
1.5
0.4
1.9
Operating
0.7
0.1
0.9
Gross
2.2
0.5
2.8
Manage + Maintain
1.6
3.1
0.8
1.1
2.3
2.7
4.9
Research
4.5
0.6
5.6
7.3
6.1
13.3
Children in DePICTRB
14,023
37,500
51,523
Cost per child
$518
$161
$259

4. DePICTRB Cost (Million, USD, 0.8 CND) Years 1 - 5 Years 6 - 10 10 Year
Personnel
Project Coordination
2.4
1.5
3.9
Informatics
0.6
0.5
1.1
Research
2.2
2.3
4.5
Gross
5.2
4.2
9.4
Operating
Office Space
1.0
2.0
Travel
0.3
0.1
0.4
Equipment
0.2
Utilities
Other
0.9
2.1
1.8
7.3
6.1
13.3
Children in DePICTRB
14,023
37,500
51,523
Cost per child
$518
$161
$258

5. 2114 2052 Retinoblastoma Cases by Region 2016 Sub-Saharan Africa
Total Pop'n (2016 est) (million)
Birth Rate*
Infant Mortality Rate**
Forecast Births (million)
Forecast Retinoblastoma (1/17000)
Sub-Saharan Africa
1033 37 53
35.9
2114
South Asia
1766 21 39
34.9
2052
East Asia & Pacific
2297 14
30.9
1820
Europe & Central Asia
912 12 8
11.2
658
Latin America & Caribbean
638 17 15
10.7
632
Arab World
406 26 29
10.4
614
Middle East & North Africa
437 23 20
10.0
587
North America
359 5
4.4
258
Central Europe and the Baltics
103 10
1.0 59
Caribbean small states 7 16
0.1
Pacific island small states 2 24 3
Sources: World Bank
*births per 1,000 population (2015)
**deaths per 1,000 live births (2016)

6. 8080 Total Forecast Retinoblastoma Cases 2016 1442 971 234 World India
Country Name
Total Pop'n (2016 est) (million)
Birth Rate*
Infant Mortality Rate**
Forecast Births (million)
Forecast Retinoblastoma (1/17000)
India
1,324 19 41
24.5
1442
China
1,379 12 11
16.5
971
Nigeria
186 39 74
6.8
399
Pakistan
193 29 69
5.2
304
Indonesia
261 24
4.9
291
United States
323 6
4.0
234
Bangladesh
163 34
3.0
179
Ethiopia
102 32 45
3.2
Congo, Democratic Republic 79 43 78
3.1
183
Brazil
208 14
2.9
173
Philippines
103 23
2.4
139
Kenya 48 38
1.5 87
Canada 36 5
0.4
World
7,442 1
10435
137.4
8080
Sources: World Bank
*births per 1,000 population (2015)
**deaths per 1,000 live births (2016)

7. Nyamori JM, et al. Br J Ophthalmol. 2012;96:141-3.
6 to 11 mo DELAY Dx
North America
Unilateral Dx mean 27 mo
Bilateral Dx mean 15 mo
Kenya
Unilateral Dx mean 36 mo
Bilateral Dx mean 26 mo
T1a (A)
intraocular
extraocular
T1b (B)
T2a (C/D)
T2b (C/D)
T3 a-e (D/E) T4 ?
Nyamori JM, et al. Br J Ophthalmol. 2012;96:141-3.
3% die
70% die
One disease worldwide
Progress from invisible to ugly outside the eye and into the brain
Awareness builds from the Internet

8. 178 RB Treatment Sites September 2017
India and china
Different social models
178 RB Treatment Sites September 2017

9. Username: demo-user Password: Demo1234
DePICTRB
Disease-specific electronic Patient Illustrated Clinical Timeline RetinoBlastoma
Username: demo-user Password: Demo1234
On Internet cloud
Secure standards
Fully identified
Coded data for research
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
cT2bN0M0H1*
Group A
cT1a
Group D
cT2b
Dimaras H, Corson TW, Cobrinik D, et al. Retinoblastoma. Nature Reviews Disease Primers. 2015:15021.
*Mallipatna A, Gallie BL, Chévez-Barrios P, et al. Retinoblastoma. In: Amin MB, Edge SB, Greene FL, eds.
AJCC Cancer Staging Manual. Vol 8th Edition. New York, NY: Springer; 2017:

10. Family controls view-only access
DePICTRB
RB Site Team enters data
Family controls view-only access
Circle of Care becomes a TEAM
FAMILY controls view only access
DePICTRB = CHECKLIST
Circle of Care = TEAM

11. DePICTRB
18 Nov 2015
Child 1
20/30
right eye
cT2b
left eye
cT2b
20/400

12. DePICTRB

13. Eliminates the two underlying causes of RB mortality
DePICTRB
Eliminates the two underlying causes of RB mortality
Complex care in few centres with poor communication
DePICTRB will enable:
Global care provider communication, consultation, learning
High quality communication across whole circle of care
Inclusion of parents in circle of care
Continuity of care
No standard of care for RB, a uniquely failed evidence base
DePICTRB will:
Research treatment approaches
Develop a learning health system
Create an evidence-based standard of care
BG KH merged

14. DePICTRB $258/child Zero deaths 2028
Not quite right….that is th cost in year 10 for the newly diagnosed in year 10
Should work out total for all kids over the 10 year?
And also the number of centers.....part way estimated in .xls