Comparative Effectiveness of Tumor Response Assessment Methods: Standard of Care Versus Computer-Assisted Response Evaluation
| Autor: | Matthew S. Davenport, Kelly Cox, Seth T. Lirette, Michael Griswold, Zhen J. Wang, Erick M. Remer, Amit Vasanji, Candace M Howard-Claudio, Jacob Bieszczad, Atul B. Shinagare, Hyunseon C. Kang, Edward Florez, Brian I. Rini, Judd M. Storrs, Brian C. Allen, Balaji Ganeshan, Ajit H. Goenka, Andrew D. Smith, Reza Sirous, J. Clark Henegan, Rupan Sanyal, Sadhna B. Nandwana |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Standard of care Quality Assurance Health Care MEDLINE Medical Oncology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Neoplasms Surveys and Questionnaires Image Processing Computer-Assisted Medicine Humans Multicenter Studies as Topic Medical physics Aged Observer Variation business.industry Sunitinib Retrospective cohort study Standard of Care General Medicine Middle Aged medicine.disease Surgery Clinical trial Treatment Outcome Clinical Trials Phase III as Topic 030220 oncology & carcinogenesis Female Metric (unit) business Tomography X-Ray Computed Quality assurance Medical Informatics medicine.drug |
| Zdroj: | JCO clinical cancer informatics. 1 |
| ISSN: | 2473-4276 |
| Popis: | Purpose To compare the effectiveness of metastatic tumor response evaluation with computed tomography using computer-assisted versus manual methods. Materials and Methods In this institutional review board–approved, Health Insurance Portability and Accountability Act–compliant retrospective study, 11 readers from 10 different institutions independently categorized tumor response according to three different therapeutic response criteria by using paired baseline and initial post-therapy computed tomography studies from 20 randomly selected patients with metastatic renal cell carcinoma who were treated with sunitinib as part of a completed phase III multi-institutional study. Images were evaluated with a manual tumor response evaluation method (standard of care) and with computer-assisted response evaluation (CARE) that included stepwise guidance, interactive error identification and correction methods, automated tumor metric extraction, calculations, response categorization, and data and image archiving. A crossover design, patient randomization, and 2-week washout period were used to reduce recall bias. Comparative effectiveness metrics included error rate and mean patient evaluation time. Results The standard-of-care method, on average, was associated with one or more errors in 30.5% (6.1 of 20) of patients, whereas CARE had a 0.0% (0.0 of 20) error rate ( P < .001). The most common errors were related to data transfer and arithmetic calculation. In patients with errors, the median number of error types was 1 (range, 1 to 3). Mean patient evaluation time with CARE was twice as fast as the standard-of-care method (6.4 minutes v 13.1 minutes; P < .001). Conclusion CARE reduced errors and time of evaluation, which indicated better overall effectiveness than manual tumor response evaluation methods that are the current standard of care. |
| Databáze: | OpenAIRE |
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