The app’s engineering was kicked off after UVA researchers invited 22 experts in the field to provide feedback on their approach and identify the most urgent needs in the process.
The group included prostate cancer patients, surgeons, oncologists, biomedical informatics experts, and industry representatives to discuss how a new tool could assist patients in improving treatment decisions after prostate removal.
A paper resulted from the inquiry and was published in the journal BMC Medical Informatics and Decision Making. It was titled “Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy.”
Based on the stakeholders’ input, researchers concluded that patients needed a way to compare treatment options in a personalized fashion, incorporating factors like age, personal priorities, genomics-defined risk of cancer recurrence, and other health conditions.
“We basically have an analytic model, and we have a mock-up of what the app should look like,” Dr. Timothy Showalter, MD, a co-author of the publication and a radiation oncologist at UVA, said in a press release.
“The idea for this is that patients could play with the model themselves and adjust it a little bit and see the changes [in terms of potential outcomes and side effects],” he said. “It would be for discussion with their doctor. It’s not a tool from which to make a clinical decision, but it could help facilitate the decision and add some clarity.”
The new tool is being developed in response to the needs identified by the 22 stakeholders. One of the priorities identified in the discussion was that the tool should be useful both during a doctor’s visit and at home, so that patients could discuss treatment options with their physician and then compare the different scenarios later with their family.
“Most stakeholders felt very strongly that the information should be available wherever the patient wants it,” Showalter said. “There should be a private web portal, there should be the ability to print, and it should be available both at home, before the physician appointment, and in the doctor’s office as well. And it should be used as part of that conversation with the physician about making a decision about whether to use radiation and the effects that might have.”
The approach could help incorporate patient-specific factors as well, such as age and personal preferences and outcomes, and cancer genomics when available, to estimate an individual’s risk of recurrence.
Questions that could be answered with this tool include “radiation likely to extend their life?” or “how might it affect their quality of life?”
“Our approach lets us put in things like different weights depending on their preferences for certain outcomes,” Showalter added. “So if it’s really important to a man to minimize his risk of urinary trouble, for example, he can weight that more heavily.”
While the tool can benefit these patients, it can ultimately be used by a broader spectrum of people to help them make complex care decisions based on their specific tumor’s genomic information.
Future steps include applying for grant funding or partnering with a company to continue developing the tool, and engineering it so that it can eventually be used by patients of other types of cancer, as well.
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