Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer
Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer
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DOI：
10.1200/jco.2001.19.4.980
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发表时间：
2001-02-15
影响因子：
45.3
通讯作者：
Parker, HL
中科院分区：
文献类型：
--
作者：
Ravdin, PM;Siminoff, LA;Parker, HL
目的：计算机辅助程序的目标！是让健康专业人员和他们的早期乳腺癌患者对辅助治疗做出更明智的决定。精算分析用于预测有和无辅助治疗患者的结局，其依据是主要来自监测、流行病学和最终结果数据的预后估计以及基于1998年辅助治疗随机试验综述的辅助治疗疗效估计。这些估计可以使用预后因素影响计算器，它使用贝叶斯方法，使调整的基础上赋予的相对风险和患病率的积极测试results.Results：从条目的患者信息（年龄，绝经状态，合并症估计）和肿瘤分期和特征（肿瘤大小，阳性腋窝淋巴结的数量，雌激素受体状态），基线预后估计。内分泌治疗（他莫昔芬治疗5年）和综合化疗（环磷酰胺/甲氨蝶呤/氟尿嘧啶类方案，或蒽环类药物治疗，或蒽环类药物和紫杉烷类药物治疗）的疗效估计值可用于预测以数字和图形形式呈现的结局。总生存期和无病生存期的结局以及临床试验中观察到的改善通过佐剂1合理建模，尽管不可能对所有治疗选择的所有患者亚组进行理想验证。还可以产生对剩余预期寿命和长期生存曲线的其他推测性估计。帮助文件提供有关乳腺癌的一般信息。该计划的互联网链接提供国家治疗指南，合作组试验选项，和其他相关information.Conclusion：计算机程序Adjuvantl可以在临床环境中发挥实用和教育作用。
Purpose: The goal of the computer program Adjuvant! is to allow health professionals and their patients with early breast cancer to make more informed decisions about adjuvant therapy.Methods: Actuarial analysis was used to project outcomes of patients with and without adjuvant therapy based on estimates of prognosis largely derived from Surveillance, Epidemiology, and End-Results data and estimates of the efficacy of adjuvant therapy based on the 1998 overviews of randomized trials of adjuvant therapy. These estimates can be refined using the Prognostic Factor Impact Calculator, which uses a Bayesian method to make adjustments based on relative risks conferred and prevalence of positive test results.Results: From the entries of patient information (age, menopausal status, comorbidity estimate) and tumor staging and characteristics (tumor size, number of positive axillary nodes, estrogen receptor status), baseline prognostic estimates are made. Estimates for the efficacy of endocrine therapy (5 years of tamoxifen) and of polychemotherapy (cyclophosphamide/methotrexate/fluorouracil-like regimens, or anthracyclinebased therapy, or therapy based on both an anthracycline and a taxane) can then be used to project outcomes presented in both numerical and graphical formats. Outcomes for overall survival and disease-free survival and the improvement seen in clinical trials, are reasonably modeled by Adjuvantl, although an ideal validation for all patient subsets with all treatment options is not possible. Additional speculative estimates of years of remaining life expectancy and long-term survival curves can also be produced. Help files supply general information about breast cancer. The program's Internet links supply national treatment guidelines, cooperative group trial options, and other related information.Conclusion: The computer program Adjuvantl can play practical and educational roles in clinical settings.