Computer system for assisting with clinical interpretation of tumour marker data.

Abstract:

OBJECTIVE:To design and evaluate a computer advisory system for the treatment of gestational trophoblastic tumour. DESIGN:A comparison of clinicians' treatment decisions with those of the computer system. Two datasets were used: one to calibrate the system and one to independently evaluate it. SETTING:Department of medical oncology. PATIENTS:Computerised records of 290 patients with low risk gestational trophoblastic tumour for whom the advisory system could predict the adequacy of treatment. The calibration set comprised patients admitted during 1979-86(227) and the test set patients during 1986-89(63). MAIN OUTCOME MEASURES:The system's accuracy in predicting need to change treatment compared with clinicians' actions. The mean time faster that the system was in predicting the need to change treatment. RESULTS:On the calibration dataset the system was 94% (164/174) accurate in predicting patients whose treatment was adequate, recommending change when none occurred in only 10 (6%) patients. In patients whose treatment was changed the system recommended change earlier than clinicians in 39/53 cases (74%), with a mean time advantage of 14.9 (SE 2.02) days. On the test dataset the system had an accuracy of 91% (31/34) in predicting treatment adequacy and a false positive rate of 9% (3/34). The system recommended change earlier than clinicians in 22/29 cases (76%), with a mean time advantage of 12.5 (2.22) days. CONCLUSIONS:The computer advisory system could improve patient management by reducing the time spent receiving ineffective treatment. This has implications for both patient time and clinical costs.

journal_name

BMJ

authors

Leaning MS,Gallivan S,Newlands ES,Dent J,Brampton M,Smith DB,Bagshawe KD

doi

10.1136/bmj.305.6857.804

keywords:

subject

Has Abstract

pub_date

1992-10-03 00:00:00

pages

804-7

issue

6857

eissn

0959-8138

issn

1756-1833

journal_volume

305

pub_type

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