Using OncoDoc as a computer-based eligibility screening system to improve accrual onto breast cancer clinical trials

  • Authors:

  • Brigitte Séroussi;Jacques Bouaud

  • Affiliations:

  • Research Mission for Medical Information Science and Technology, Department of Applied Projects, Direction of Information Systems, Assistance Publique-Hôpitaux de Paris, 91 boulevard de l'H&# ...;Research Mission for Medical Information Science and Technology, Department of Applied Projects, Direction of Information Systems, Assistance Publique-Hôpitaux de Paris, 91 boulevard de l'H&# ...

  • Venue:
  • Artificial Intelligence in Medicine
  • Year:
  • 2003

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Abstract

While clinical trials offer cancer patients the optimum treatment, historical accrual of such patients has not been very successful. OncoDoc is a decision support system designed to provide best therapeutic recommendations for breast cancer patients. Developed as a browsing tool of a knowledge base structured as a decision tree, OncoDoc allows physicians to control the contextual instantiation of patient characteristics to build the best formal equivalent of an actual patient. Used as a computer-based eligibility screening system, depending on whether instantiated patient parameters are matched against guideline knowledge or available clinical trial protocols, it provides either evidence-based therapeutic options or relevant patient-specific clinical trials. Implemented at the Gustave Roussy Institute and routinely used at the point of care during a 4-month period, it significantly improved physician compliance with guideline recommendations and enhanced physician awareness of open trials while increasing patient enrolment to clinical trials by 50%. But, when analyzing reasons of non-accrual of potentially eligible patients, it appeared that physicians' psychological reluctance to refer patients to clinical trials, measured during the experiment at 25%, may not be resolved by the simple dissemination of clinical trial information at the point of care.