Department of Gastroenterology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Department of Oncology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Can J Gastroenterol Hepatol. 2019 Feb 3;2019:8072928. doi: 10.1155/2019/8072928. eCollection 2019.
BACKGROUNDS/AIMS: Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the latest evidence and guidelines. However, studies of the concordance rate between WFO and clinicians for advanced gastric cancer (AGC) are lacking.
We retrospectively reviewed 65 patients with AGC who consulted WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of the GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment option), and not recommended.
In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the study. The concordance rate between WFO and the GMDT was 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for consideration level. The main causes of discordance between WFO and the GMDT were as follows. First, WFO did not consider the medical history. Second, WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted to be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended by WFO for financial reasons as they were not covered by medical insurance.
The concordance rate at the recommended level was relatively low but was higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil Medical Center (GMC) and the Memorial Sloan Kettering Cancer Center (MSKCC), the main WFO consulting center. The utility of WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines.
背景/目的: Watson for Oncology(WFO)是一种认知技术,通过分析最新的证据和指南来处理医学信息。然而,目前缺乏关于 WFO 与临床医生在治疗晚期胃癌(AGC)方面的一致性的研究。
我们回顾性分析了 2016 年和 2017 年咨询 WFO 和加图吉尔医疗中心多学科团队(GMDT)的 65 例 AGC 患者。将 WFO 的建议与 GMDT 的意见进行比较。WFO 提供了三种治疗选择:推荐(首选治疗方案)、考虑(次选治疗方案)和不推荐。
共纳入 65 例患者(平均年龄 61.0 岁;44 例男性,21 例女性)。WFO 与 GMDT 的一致性率在推荐水平为 41.5%(27/65),在考虑水平为 87.7%(57/65)。WFO 与 GMDT 不一致的主要原因如下。首先,WFO 未考虑患者的病史。其次,WFO 推荐使用在韩国被认为过时的药物。第三,一些患者希望参与临床试验。第四,一些患者因经济原因拒绝使用 WFO 推荐的生物制剂,因为这些药物未被医疗保险覆盖。
推荐水平的一致性相对较低,但在考虑水平较高。不一致主要源于加图吉尔医疗中心(GMC)和 WFO 的主要咨询中心纪念斯隆凯特琳癌症中心(MSKCC)之间不同的医疗环境。通过纳入区域指南,可以进一步提高 WFO 作为支持临床决策工具的实用性。