Abstract

Objective

IBM^(R) Watson for Oncology (WfO) is a clinical decision-support system (CDSS) that provides evidence-informed therapeutic options to cancer-treating clinicians. A panel of experienced oncologists compared CDSS treatment options to treatment decisions made by clinicians to characterize the quality of CDSS therapeutic options and decisions made in practice.

Methods

This study included patients treated between 1/2017 and 7/2018 for breast, colon, lung, and rectal cancers at Bumrungrad International Hospital (BIH), Thailand. Treatments selected by clinicians were paired with therapeutic options presented by the CDSS and coded to mask the origin of options presented. The panel rated the acceptability of each treatment in the pair by consensus, with acceptability defined as compliant with BIH’s institutional practices. Descriptive statistics characterized the study population and treatment-decision evaluations by cancer type and stage.

Results

Nearly 60% (187) of 313 treatment pairs for breast, lung, colon, and rectal cancers were identical or equally acceptable, with 70% (219) of WfO therapeutic options identical to, or acceptable alternatives to, BIH therapy. In 30% of cases (94), 1 or both treatment options were rated as unacceptable. Of 32 cases where both WfO and BIH options were acceptable, WfO was preferred in 18 cases and BIH in 14 cases. Colorectal cancers exhibited the highest proportion of identical or equally acceptable treatments; stage IV cancers demonstrated the lowest.

Conclusion

This study demonstrates that a system designed in the US to support, rather than replace, cancer-treating clinicians provides therapeutic options which are generally consistent with recommendations from oncologists outside the US.

中文翻译：

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肿瘤学临床决策支持系统的建议与实际治疗决策的比较

 抽象的

 客观的

IBM ^(R) Watson for Oncology (WfO) 是一个临床决策支持系统 (CDSS)，为癌症治疗临床医生提供循证治疗选择。由经验丰富的肿瘤学家组成的小组将 CDSS 治疗方案与临床医生做出的治疗决策进行比较，以表征 CDSS 治疗方案和实践决策的质量。

 方法

这项研究包括 2017 年 1 月至 2018 年 7 月期间在泰国康民国际医院 (BIH) 接受乳腺癌、结肠癌、肺癌和直肠癌治疗的患者。临床医生选择的治疗方法与 CDSS 提出的治疗方案相匹配，并进行编码以掩盖所提出方案的来源。专家组以协商一致方式对这对治疗中每种治疗的可接受性进行评级，可接受性定义为符合 BIH 的机构实践。描述性统计按癌症类型和阶段描述了研究人群和治疗决策评估。

 结果

313 个乳腺癌、肺癌、结肠癌和直肠癌治疗对中，近 60% (187) 是相同或同样可接受的，其中 70% (219) 的 WfO 治疗选择与 BIH 治疗相同或可接受的替代方案。在 30% 的病例 (94) 中，一种或两种治疗方案被评为不可接受。在 32 例 WfO 和 BIH 选项均可接受的病例中，18 例首选 WfO，14 例首选 BIH。结直肠癌表现出最高比例的相同或同等可接受的治疗； IV 期癌症表现最低。

 结论

这项研究表明，在美国设计的一个用于支持而不是取代癌症治疗临床医生的系统提供的治疗选择通常与美国以外的肿瘤学家的建议一致。