1. Is There A Strategy To Increase Accrual?

2. Tracking Down the Potential Patient Hospital Admissions Type of cancer cases. Which doctors admitted them. Who referred them to the admitting doctor. From where were they referred.

3. Tracking Down the Potential Patient Physician Offices (more difficult to do) Type of cases seen What are their referral patterns

4. Tracking Down the Potential Patient Public Health services Demographics Health services available Clinics and Nursing

5. How does a patient get on a protocol? Some Symptoms-> Action -> No ->MD Dx ->Rx or Refer -> Specialist Protocol ->Treatment.

6. Physician or Specialist PERSONAL meeting CME lectures Economic stake Personnel support Money/patient

7. Physician or Specialist Prestige Highlight involvement Part of decision making Follow the patients Hotline for help or complaints

8. Physician or Specialist Do not forget: Radiologist Pathologist Surgeon and others

9. Patient Environment Family Church NeighborsCommunity Center Education levelSocial Worker Economic statusTransportation

10. NIH Research: – “Southern Research” Reputation

11. Presentations to the general public Community Centers Churches Schools Workplaces American Cancer Society

12. Presentations to the general public Advertising Local new papers Marketing Public Relations Radio and T.V. interviews

13. Pitfalls of Community Medical Research Research Generates Institutional Review Board Protocol Monitoring Data Safety and Monitoring Need for medical and administrative expertise RTOG Paperwork Deviation from normal procedures

14. Pitfalls of Community Medical Research Physician Apathy May loose control of decision making Different from what they do Time consuming

15. Pitfalls of Community Medical Research Hospital Administration No experience with Fed. Grants No compliance expertise