Gild Philipp, Rink Michael, Meyer Christian P
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Center for Surgery and Public Health, Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Transl Androl Urol. 2017 Dec;6(6):1123-1131. doi: 10.21037/tau.2017.11.13.
Gauging prognosis is a key element when facing treatment decisions in cancer care. Several prognostic tools, such as risk tables and nomograms are at hand to aid this process. In the context of patient-centered care, prognostic tools are of great interest to caregivers and -providers alike, as they can convey sizeable amounts of information and provide tailored, accurate estimates of prognosis. Given the rising number of prognostic tools in cancer care over the last two decades, and similarly, ever increasing presence of the Internet, we aimed to assess how this would translate into the availability of online tools for patient counseling. We used a modified systematic review to evaluate the web-based availability, format, and content of prognostic tools for bladder and kidney cancer care. Our search identified a total of twenty-three tools, offered by eight providers, which assessed a total of six (bladder cancer) and five (kidney cancer) different outcomes. Despite the restricted availability of online tools, we observed that the majority showed limited user-friendliness (including, for example, a statement/explanation of intended use, visualization of data, availability as application software for handheld devices). Only one tool included modifiable risk factors such as smoking behavior and body weight. Lastly, none of the tools incorporated genomic or molecular markers or treatment associated quality of life. Taken together, online tools for patient counseling in bladder and kidney cancer care are only beginning to align with the growing need in clinical reality. Further and future avenues include incorporation of health-related quality of life as well as genomic and biomarkers into prediction tools.
在癌症治疗决策过程中，评估预后是一个关键因素。有几种预后工具，如风险表和列线图，可用于辅助这一过程。在以患者为中心的医疗背景下，预后工具对护理人员和医疗服务提供者都非常重要，因为它们可以传达大量信息，并提供量身定制的、准确的预后估计。鉴于在过去二十年中癌症治疗领域预后工具的数量不断增加，同样地，互联网的普及程度也日益提高，我们旨在评估这将如何转化为用于患者咨询的在线工具的可用性。我们采用了一种改进的系统评价方法，以评估用于膀胱癌和肾癌治疗的预后工具的网络可用性、格式和内容。我们的搜索共识别出八个提供者提供的二十三种工具，这些工具总共评估了六种（膀胱癌）和五种（肾癌）不同的结果。尽管在线工具的可用性有限，但我们观察到大多数工具的用户友好性有限（包括例如对预期用途的说明/解释、数据可视化、作为手持设备应用软件的可用性）。只有一种工具纳入了可改变的风险因素，如吸烟行为和体重。最后，没有一种工具纳入基因组或分子标记或与治疗相关的生活质量。综上所述，用于膀胱癌和肾癌患者咨询的在线工具才刚刚开始与临床现实中不断增长的需求相匹配。未来的进一步方向包括将与健康相关的生活质量以及基因组和生物标志物纳入预测工具。
