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Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists

INTRODUCTION: Cognitive computing point‐of‐care decision support tools which ingest patient attributes from electronic health records and display treatment options based on expert training and medical literature, supplemented by real world evidence (RWE), might prove useful to expert and novice onco...

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Autores principales: McNamara, Donna M., Goldberg, Stuart L., Latts, Lisa, Atieh Graham, Deena M., Waintraub, Stanley E., Norden, Andrew D., Landstrom, Cody, Pecora, Andrew L., Hervey, John, Schultz, Eric V., Wang, Ching-Kun, Jungbluth, Nicholas, Francis, Phillip M., Snowdon, Jane L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825991/
https://www.ncbi.nlm.nih.gov/pubmed/31509353
http://dx.doi.org/10.1002/cam4.2548
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author McNamara, Donna M.
Goldberg, Stuart L.
Latts, Lisa
Atieh Graham, Deena M.
Waintraub, Stanley E.
Norden, Andrew D.
Landstrom, Cody
Pecora, Andrew L.
Hervey, John
Schultz, Eric V.
Wang, Ching-Kun
Jungbluth, Nicholas
Francis, Phillip M.
Snowdon, Jane L.
author_facet McNamara, Donna M.
Goldberg, Stuart L.
Latts, Lisa
Atieh Graham, Deena M.
Waintraub, Stanley E.
Norden, Andrew D.
Landstrom, Cody
Pecora, Andrew L.
Hervey, John
Schultz, Eric V.
Wang, Ching-Kun
Jungbluth, Nicholas
Francis, Phillip M.
Snowdon, Jane L.
author_sort McNamara, Donna M.
collection PubMed
description INTRODUCTION: Cognitive computing point‐of‐care decision support tools which ingest patient attributes from electronic health records and display treatment options based on expert training and medical literature, supplemented by real world evidence (RWE), might prove useful to expert and novice oncologists. The concordance of augmented intelligence systems with best medical practices and potential influences on physician behavior remain unknown. METHODS: Electronic health records from 88 breast cancer patients evaluated at a USA tertiary care center were presented to subspecialist experts and oncologists focusing on other disease states with and without reviewing the IBM Watson for Oncology with Cota RWE platform. RESULTS: The cognitive computing “recommended” option was concordant with selection by breast cancer experts in 78.5% and “for consideration” option was selected in 9.4%, yielding agreements in 87.9%. Fifty‐nine percent of non‐concordant responses were generated from 8% of cases. In the Cota observational database 69.3% of matched controls were treated with “recommended,” 11.4% “for consideration”, and 19.3% “not recommended.” Without guidance from Watson for Oncology (WfO)/Cota RWE, novice oncologists chose 75.5% recommended/for consideration treatments which improved to 95.3% with WfO/Cota RWE. The novices were more likely than experts to choose a non‐recommended option (P < .01) without WfO/Cota RWE and changed decisions in 39% cases. CONCLUSIONS: Watson for Oncology with Cota RWE options were largely concordant with disease expert judged best oncology practices, and was able to improve treatment decisions among breast cancer novices. The observation that nearly a fifth of patients with similar disease characteristics received non‐recommended options in a real world database highlights a need for decision support.
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spelling pubmed-68259912019-11-07 Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists McNamara, Donna M. Goldberg, Stuart L. Latts, Lisa Atieh Graham, Deena M. Waintraub, Stanley E. Norden, Andrew D. Landstrom, Cody Pecora, Andrew L. Hervey, John Schultz, Eric V. Wang, Ching-Kun Jungbluth, Nicholas Francis, Phillip M. Snowdon, Jane L. Cancer Med Clinical Cancer Research INTRODUCTION: Cognitive computing point‐of‐care decision support tools which ingest patient attributes from electronic health records and display treatment options based on expert training and medical literature, supplemented by real world evidence (RWE), might prove useful to expert and novice oncologists. The concordance of augmented intelligence systems with best medical practices and potential influences on physician behavior remain unknown. METHODS: Electronic health records from 88 breast cancer patients evaluated at a USA tertiary care center were presented to subspecialist experts and oncologists focusing on other disease states with and without reviewing the IBM Watson for Oncology with Cota RWE platform. RESULTS: The cognitive computing “recommended” option was concordant with selection by breast cancer experts in 78.5% and “for consideration” option was selected in 9.4%, yielding agreements in 87.9%. Fifty‐nine percent of non‐concordant responses were generated from 8% of cases. In the Cota observational database 69.3% of matched controls were treated with “recommended,” 11.4% “for consideration”, and 19.3% “not recommended.” Without guidance from Watson for Oncology (WfO)/Cota RWE, novice oncologists chose 75.5% recommended/for consideration treatments which improved to 95.3% with WfO/Cota RWE. The novices were more likely than experts to choose a non‐recommended option (P < .01) without WfO/Cota RWE and changed decisions in 39% cases. CONCLUSIONS: Watson for Oncology with Cota RWE options were largely concordant with disease expert judged best oncology practices, and was able to improve treatment decisions among breast cancer novices. The observation that nearly a fifth of patients with similar disease characteristics received non‐recommended options in a real world database highlights a need for decision support. John Wiley and Sons Inc. 2019-09-11 /pmc/articles/PMC6825991/ /pubmed/31509353 http://dx.doi.org/10.1002/cam4.2548 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
McNamara, Donna M.
Goldberg, Stuart L.
Latts, Lisa
Atieh Graham, Deena M.
Waintraub, Stanley E.
Norden, Andrew D.
Landstrom, Cody
Pecora, Andrew L.
Hervey, John
Schultz, Eric V.
Wang, Ching-Kun
Jungbluth, Nicholas
Francis, Phillip M.
Snowdon, Jane L.
Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title_full Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title_fullStr Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title_full_unstemmed Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title_short Differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
title_sort differential impact of cognitive computing augmented by real world evidence on novice and expert oncologists
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825991/
https://www.ncbi.nlm.nih.gov/pubmed/31509353
http://dx.doi.org/10.1002/cam4.2548
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