Msaouel Pavlos, Lee Juhee, Thall Peter F
Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancers (Basel). 2021 Jun 1;13(11):2741. doi: 10.3390/cancers13112741.
We argue that well-informed patient-specific decision-making may be carried out as three consecutive tasks: (1) estimating key parameters of a statistical model, (2) using prognostic information to convert these parameters into clinically interpretable values, and (3) specifying joint utility functions to quantify risk-benefit trade-offs between clinical outcomes. Using the management of metastatic clear cell renal cell carcinoma as our motivating example, we explain the role of prognostic covariates that characterize between-patient heterogeneity in clinical outcomes. We show that explicitly specifying the joint utility of clinical outcomes provides a coherent basis for patient-specific decision-making.
我们认为，基于充分信息的患者特异性决策可作为三个连续任务来进行：（1）估计统计模型的关键参数；（2）利用预后信息将这些参数转化为临床可解释的值；（3）指定联合效用函数以量化临床结果之间的风险-收益权衡。以转移性透明细胞肾细胞癌的管理作为我们的激励示例，我们解释了表征患者间临床结果异质性预后协变量的作用。我们表明，明确指定临床结果的联合效用为患者特异性决策提供了一个连贯的基础。
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