Levy Mia A, Rubin Daniel L
Stanford University, Stanford, CA, USA.
AMIA Annu Symp Proc. 2008 Nov 6;2008:399-403.
Objective criteria for measuring response to cancer treatment are critical to clinical research and practice. The National Cancer Institute has developed the Response Evaluation Criteria in Solid Tumors (RECIST) method to quantify treatment response. RECIST evaluates response by assessing a set of measurable target lesions in baseline and follow-up radiographic studies. However, applying RECIST consistently is challenging due to inter-observer variability among oncologists and radiologists in choice and measurement of target lesions. We analyzed the radiologist-oncologist workflow to determine whether the information collected is sufficient for reliably applying RECIST. We evaluated radiology reports and image markup (radiologists), and clinical flow sheets (oncologists). We found current reporting of radiology results insufficient for consistent application of RECIST, compared with flow sheets. We identified use cases and functional requirements for an informatics tool that could improve consistency and accuracy in applying methods such as RECIST.
衡量癌症治疗反应的客观标准对临床研究和实践至关重要。美国国立癌症研究所已制定实体瘤疗效评价标准（RECIST）方法来量化治疗反应。RECIST通过评估基线和随访影像学研究中的一组可测量目标病灶来评估反应。然而，由于肿瘤学家和放射科医生在目标病灶的选择和测量上存在观察者间差异，始终如一地应用RECIST具有挑战性。我们分析了放射科医生与肿瘤学家的工作流程，以确定所收集的信息是否足以可靠地应用RECIST。我们评估了放射学报告和图像标记（放射科医生）以及临床流程表（肿瘤学家）。我们发现，与流程表相比，目前放射学结果报告不足以始终如一地应用RECIST。我们确定了一个信息学工具的用例和功能要求，该工具可以提高应用RECIST等方法的一致性和准确性。
