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个体化癌症预后预测和知情同意。

Tailored cancer outcome prediction and informed consent.

机构信息

Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195,USA.

出版信息

Semin Oncol. 2010 Feb;37(1):47-52. doi: 10.1053/j.seminoncol.2009.12.008.

Abstract

Clinically relevant disparities in the outcomes of cancer treatment between institutions are well established. Some authors have argued that physicians have an ethical obligation to disclose these disparities as part of the informed consent process.(1) We believe that preservation of patient autonomy requires disclosure of treatment institution-specific outcomes and that statistical prediction models tailored to individual patients are the best way to frame this discussion. We describe a utopian system to gather and disseminate cancer outcome data based on the United Network for Organ Sharing and articulate why accurate and equitable prediction models are feasible both scientifically and logistically. We also discuss strategies of design and oversight required to mitigate any unintended negative downstream consequences of such a system.

摘要

医疗机构之间癌症治疗结果的临床相关差异是众所周知的。一些作者认为,医生有道德义务披露这些差异,作为知情同意过程的一部分。(1)我们认为,维护患者自主权需要披露特定治疗机构的结果,并且针对个体患者定制的统计预测模型是讨论这种情况的最佳方式。我们描述了一个基于美国器官共享网络收集和传播癌症结果数据的乌托邦系统,并阐明了准确和公平的预测模型在科学和逻辑上都是可行的。我们还讨论了设计和监督所需的策略,以减轻此类系统的任何意外负面下游后果。

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