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Article: Utility of a web-based breast cancer predictive algorithm for adjuvant chemotherapeutic decision making in a multidisciplinary oncology center

TitleUtility of a web-based breast cancer predictive algorithm for adjuvant chemotherapeutic decision making in a multidisciplinary oncology center
Authors
KeywordsBreast neoplasms
Cancer chemotherapy
Clinical decision support software
Issue Date2006
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/07357907.asp
Citation
Cancer Investigation, 2006, v. 24 n. 4, p. 367-373 How to Cite?
AbstractPurpose: Adjuvant drug therapy can extend survival for breast cancer patients, but the balance between costs and benefits may be difficult to estimate. Software programs have been developed for this purpose and recently have become available online. Here, we describe our experience using a web-based program to support adjuvant decision making at a multidisciplinary breast cancer Tumor Board in a university-affiliated oncology center. Patients and Methods: One hundred two adjuvant breast cancer cases were discussed by the Tumor Board over a four-month period, with a provisional treatment plan being formulated after each discussion. Program data predicting 10-year risks and benefits were shared with board members after each provisional plan and any change in recommendation was recorded. A user survey was conducted to assess the perceived strengths and weaknesses of the program. Results: Treatment decisions were changed in 12.7 percent of cases (13/102) after consideration of data from the program. Most of these (76.9 percent) were node-negative ER-positive cases, with the most common reason for change being a lower-than-expected added survival benefit from less intensive chemotherapy regimens (ACx4 or CMF; 81.8 percent). In certain recurrent scenarios, the program was perceived to have limitations that led to retention of the original management plan despite data that might otherwise have favored different treatment. On completion of the study period, clinicians' attitudes to the program ranged from enthusiasm to caution. Conclusion: Although not replacing clinical judgement, these findings support the value of this web-based program as a decision making adjunct that can help clinicians to separate risk and benefit, compare the added value of different therapeutic interventions in a given clinical context, and present more balanced information about treatment options to patients. Copyright © Taylor & Francis Group, LLC.
Persistent Identifierhttp://hdl.handle.net/10722/76554
ISSN
2015 Impact Factor: 2.231
2015 SCImago Journal Rankings: 0.991
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorEpstein, Ren_HK
dc.contributor.authorLeung, Ten_HK
dc.contributor.authorMak, Jen_HK
dc.contributor.authorCheung, Pen_HK
dc.date.accessioned2010-09-06T07:22:28Z-
dc.date.available2010-09-06T07:22:28Z-
dc.date.issued2006en_HK
dc.identifier.citationCancer Investigation, 2006, v. 24 n. 4, p. 367-373en_HK
dc.identifier.issn0735-7907en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76554-
dc.description.abstractPurpose: Adjuvant drug therapy can extend survival for breast cancer patients, but the balance between costs and benefits may be difficult to estimate. Software programs have been developed for this purpose and recently have become available online. Here, we describe our experience using a web-based program to support adjuvant decision making at a multidisciplinary breast cancer Tumor Board in a university-affiliated oncology center. Patients and Methods: One hundred two adjuvant breast cancer cases were discussed by the Tumor Board over a four-month period, with a provisional treatment plan being formulated after each discussion. Program data predicting 10-year risks and benefits were shared with board members after each provisional plan and any change in recommendation was recorded. A user survey was conducted to assess the perceived strengths and weaknesses of the program. Results: Treatment decisions were changed in 12.7 percent of cases (13/102) after consideration of data from the program. Most of these (76.9 percent) were node-negative ER-positive cases, with the most common reason for change being a lower-than-expected added survival benefit from less intensive chemotherapy regimens (ACx4 or CMF; 81.8 percent). In certain recurrent scenarios, the program was perceived to have limitations that led to retention of the original management plan despite data that might otherwise have favored different treatment. On completion of the study period, clinicians' attitudes to the program ranged from enthusiasm to caution. Conclusion: Although not replacing clinical judgement, these findings support the value of this web-based program as a decision making adjunct that can help clinicians to separate risk and benefit, compare the added value of different therapeutic interventions in a given clinical context, and present more balanced information about treatment options to patients. Copyright © Taylor & Francis Group, LLC.en_HK
dc.languageengen_HK
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/07357907.aspen_HK
dc.relation.ispartofCancer Investigationen_HK
dc.rightsCancer Investigation. Copyright © Informa Healthcare.en_HK
dc.subjectBreast neoplasmsen_HK
dc.subjectCancer chemotherapyen_HK
dc.subjectClinical decision support softwareen_HK
dc.titleUtility of a web-based breast cancer predictive algorithm for adjuvant chemotherapeutic decision making in a multidisciplinary oncology centeren_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0735-7907&volume=24&issue=4&spage=367&epage=373&date=2006&atitle=Utility+of+a+web-based+breast+cancer+predictive+algorithm+for+adjuvant+chemotherapeutic+decision+making+in+a+multidisciplinary+oncology+center.en_HK
dc.identifier.emailEpstein, R: repstein@hku.hken_HK
dc.identifier.authorityEpstein, R=rp00501en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/07357900600705292en_HK
dc.identifier.pmid16777688-
dc.identifier.scopuseid_2-s2.0-33745325366en_HK
dc.identifier.hkuros120652en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33745325366&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume24en_HK
dc.identifier.issue4en_HK
dc.identifier.spage367en_HK
dc.identifier.epage373en_HK
dc.identifier.isiWOS:000238414500005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridEpstein, R=34975074500en_HK
dc.identifier.scopusauthoridLeung, T=16151388900en_HK
dc.identifier.scopusauthoridMak, J=7103323435en_HK
dc.identifier.scopusauthoridCheung, P=7202595368en_HK
dc.identifier.citeulike1008436-

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