Hickam D H, Shortliffe E H, Bischoff M B, Scott A C, Jacobs C D
Ann Intern Med. 1985 Dec;103(6 ( Pt 1)):928-36. doi: 10.7326/0003-4819-103-6-928.
ONCOCIN is a chemotherapy protocol advisor used experimentally in a university oncology clinic. The program combines formal protocol guidelines with judgments of oncologists who have experience adjusting therapy in complex clinical situations. We compared the chemotherapy administered by clinic physicians with the treatment that would have been recommended by ONCOCIN in 415 visits for 39 patients with lymphoma seen before the program's introduction. In 189 visits the program agreed with the therapy actually administered. In a blinded evaluation, four experts on lymphoma failed to find a significant difference between the treatments selected by physicians and those proposed by ONCOCIN. Further analyses showed that ONCOCIN tended to attenuate drug doses or delay treatment more than the experts recommended, whereas the physicians were less likely to attenuate doses to the extent the experts suggested. Our results show that ONCOCIN provides advice on lymphoma treatment similar to the treatment provided in a university oncology clinic.
ONCOCIN是一种化疗方案顾问程序,在一所大学肿瘤诊所进行实验性使用。该程序将正式的方案指南与在复杂临床情况下有调整治疗经验的肿瘤学家的判断相结合。我们比较了在该程序引入之前,诊所医生为39例淋巴瘤患者进行的415次诊疗中所给予的化疗与ONCOCIN建议的治疗方案。在189次诊疗中,该程序与实际给予的治疗方案一致。在一项盲法评估中,四位淋巴瘤专家未能发现医生选择的治疗方案与ONCOCIN提出的治疗方案之间存在显著差异。进一步分析表明,ONCOCIN倾向于比专家建议的更多地减少药物剂量或延迟治疗,而医生减少剂量的可能性则低于专家建议的程度。我们的结果表明,ONCOCIN提供的淋巴瘤治疗建议与大学肿瘤诊所提供的治疗相似。