The Evolve to Next Gen ACT (ENACT) Network is a Clinical and Translational Science Awards (CTSA) program-wide federated network that aims to significantly increase participant accrual into clinical trials. ENACT helps clinical investigators discover cohorts before the start of a trial, establish feasibility of a clinical protocol for grant applications, and identifying patients from multiple sites. The data exposed to the network consists of demographics, diagnoses, procedures, laboratory results and medications. These data are available through a user interface for defining inclusion and exclusion criteria and exploring patient cohorts and potential sites for collaboration. The University of Utah is a participating CTSA site on the ACT network.
Evolve to Next Gen ACT (ENACT) Network
The ENACT network, previously referred to as Accrual to Clinical Trials (ACT) Network, is a nationwide federation of leading academic research institutions that share aggregate patient counts from electronic health record (EHR) data. The goal of the original ACT network was to increase patent accrual to clinical trials. ENCAT expands user ability beyond queries of patient counts to allow both shared and individual statistical and machine learning analyses. ENACT builds upon the structure of the ACT Network to develop and implement new informatics tools for EHR research. ENACT is compiled by the National Center for Advancing Translational Sciences (NCATS) in collaboration with the Clinical and Translational Science Award (CTSA) consortium.
ENACT helps clinical investigators conduct cohort discovery before a trial starts, to establish feasibility of a clinical protocol for grant applications, IRB submission, etc. ACT also helps investigators identify additional sites for a clinical trial. By allowing investigators to thoroughly explore patient cohorts and potential sites before finalizing their clinical protocols, ENACT increases the odds of successfully completing clinical trial recruitment.
How to Access ENACT
ENACT is available to researchers at the University of Utah for free through access to the i2b2 tool’s multi-site: Shared Health Research Information Network (SHRINE). Once logged into the tool, researchers can run real-time queries on de-identified patient data.
To request ENACT log-in credential and for additional information Contact:
Helpdesk@ccts.utah.edu or fill out this form to gain access to ENACT
Why Use ENACT?
Funding Proposals
With ENACT, researchers can access easy-to-download results for use in funding proposals. Use ENACT to demonstrate the feasibility of your clinical study to potential funders.
Ethics/Compliance
With ENACT, researchers can access easy-to-download results for use in IRB submissions. Use ENACT to demonstrate recruitment feasibility for your study to IRB.
Study Design
With ENACT, researchers can explore patient populations in depth and in real time. At the design stage, use ENACT to learn about your patient population and iteratively test and refine clinical study parameters.
Cohort Discovery Feasibility
With ENACT, researchers can iteratively test and refine inclusion and exclusion criteria. Use ENACT to confirm the feasibility of your clinical study.
Recruitment
Under development: ENACT will introduce technology to facilitate re-identification of patients for clinical study recruitment, in accordance with each participating institution’s existing IRB protocols.
Collaboration
With ENACT, researchers can search patient populations across the CTSA network in a HIPAA-compliant manner from their desktop. Use ENACT to identify partners for multi-site studies.
Frequently Asked Questions
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ENACT provides an approximate count of the number of patients meeting the query criteria. Counts are intentionally approximate (+/-10 for each institution) in order to protect patient confidentiality. So, if you run the same query more than once, you will receive slightly different results each time. Identifiable patient data is never returned.
The accuracy of query results also depends on the accuracy of data mapping at each institution; although the ENACT Network uses uniform mapping processes, some variability across institutions may exist.
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The ENACT Network only shares aggregate patient counts, and never shares (or accesses) patient data. Each site monitors and reports on local usage of the ENACT Network to ensure compliance with the ENACT Governance Document.
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Yes. Part of the ENACT implementation process at each site involves applying for approval from the site’s IRB. The University of Utah is part of the ACT network.
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It depends on the size and complexity of your query, and on the responsiveness of local ENACT sites. Currently, the ENACT web client automatically times out requests that take longer than 3 minutes to return results. If your query is timing out, try reducing the number of variables, then adding them back incrementally. You can also set a custom timeout for a shorter duration to reduce wait times.
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ENACT uses a limited data set and does not currently index text from medical records.
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In order to remain in compliance with local IRB procedures, all patient recruitment must occur locally, by local clinical investigators. ENACT is currently developing and testing plug-ins to assist in local re-identification of eligible patients.