'Rapid Learning health care in oncology' - An approach towards decision support systems enabling customised radiotherapy'
'Rapid Learning health care in oncology' - An approach towards decision support systems enabling customised radiotherapy'
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DOI：
10.1016/j.radonc.2013.07.007
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发表时间：
2013-10-01
影响因子：
5.7
通讯作者：
Dekker, Andre
中科院分区：
文献类型：
--
作者：
Lambin, Philippe;Roelofs, Erik;Dekker, Andre
目的：概述快速学习方法、其结果以及对放射治疗的潜在影响。材料和结果：快速学习方法分为四个阶段。在数据阶段，收集有关过去患者、使用的治疗方法和结果的各种数据。支持语义互操作性的创新信息技术可以实现分布式学习和数据共享，而不会给医疗保健专业人员带来额外负担，并且不需要数据离开医院。在知识阶段，通过将机器学习方法应用于数据来开发新数据和治疗结果的预测模型。在应用阶段，这些知识通过新颖的决策支持系统或通过现有模型（例如肿瘤控制概率模型）的扩展应用于临床实践。在评估阶段，治疗结果的可预测性允许通过比较预测结果和实际结果来评估新知识。结论：个性化或量身定制的癌症治疗不仅确保患者接受最佳治疗，而且确保将正确的资源用于正确的患者。快速学习方法与循证医学相结合有望提高结果的可预测性，而放射治疗是研究快速学习价值的理想领域。下一步将是将患者的偏好纳入决策中。 (C) 2013 作者。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Purpose: An overview of the Rapid Learning methodology, its results, and the potential impact on radiotherapy.Material and results: Rapid Learning methodology is divided into four phases. In the data phase, diverse data are collected about past patients, treatments used, and outcomes. Innovative information technologies that support semantic interoperability enable distributed learning and data sharing without additional burden on health care professionals and without the need for data to leave the hospital. In the knowledge phase, prediction models are developed for new data and treatment outcomes by applying machine learning methods to data. In the application phase, this knowledge is applied in clinical practice via novel decision support systems or via extensions of existing models such as Tumour Control Probability models. In the evaluation phase, the predictability of treatment outcomes allows the new knowledge to be evaluated by comparing predicted and actual outcomes.Conclusion: Personalised or tailored cancer therapy ensures not only that patients receive an optimal treatment, but also that the right resources are being used for the right patients. Rapid Learning approaches combined with evidence based medicine are expected to improve the predictability of outcome and radiotherapy is the ideal field to study the value of Rapid Learning. The next step will be to include patient preferences in the decision making. (C) 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.