Navigation Links
Decision tool for prostate cancer patients helps men customize treatment in anxious time
Date:6/15/2009

An online decision tool created in part by a graduate student at the University of California Irvine helps men diagnosed with prostate cancer sort through an intimidating flurry of possible treatments and customize treatment plans of their own, according to a study in the current issue of Interfaces, a journal of the Institute for Operations Research and the Management Sciences (INFORMS).

"Decision Making with Prostate Cancer: A Multiple-Objective Model with Uncertainty" is by Jay Simon, who received his doctorate this spring and is scheduled to join the faculty of the Naval Postgraduate School. The study appears in a special issue of Interfaces http://interfaces.journal.informs.org/ containing applications of operations research models to healthcare problems.

His research, says Simon, "gives a patient the opportunity to see all the available information in one place and personalize it, tailor it, and incorporate his own preferences."

The tool allows men to enter their own data, compare it with available research, score different options, and derive a "life score" that guides their decision.

Making decisions about prostate cancer treatment is unique, the author writes. Patients diagnosed with other diseases often face restricted options. By contrast, because prostate cancer in many cases progresses slowly, men with the disease choose from a variety of possible cares. These can be evaluated using multiattribute utility theory, which is used by operations researches and decision scientists to evaluate trade-offs.

"Two main factors are critical in making the treatment decision," the author writes.

"First, it is necessary to quantify as probabilities the uncertainties involving death and side effects over time. A decision analyst accomplishes this mainly by collecting and analyzing historical data reported in medical journals. Second, the decision analyst must elicit the patient's individual preferences and incorporate them into the analysis. Because the outcomes involve multiple attributes (e.g., length of life and side effects), it is necessary to know the relative importance that the patient places on each attribute."

The model considers five treatment options:

  1. surgery
  2. external radiation
  3. seed radiation
  4. dual radiation
  5. no treatment

The model's tasks are specifying and evaluating the uncertainties, and evoking patient preferences. Among the uncertainties considered are patients' expected life span in the absence of cancer and probability of death following each of the treatment options.

Information considered is data from the Social Security Administration, actuarial data, and cure rates reported in medical journals.

The model uses a cancer score to examine measures of prostate cancer severity.

The model considers not only the probability of death from surgery and other procedures, but also the likelihood of enduring side effects. The model expresses the possibility of each side effect's occurrence as comparable to a specific reduction in life span. A "multiobjective" model is then used to determine patients' own preferences, allowing patients to combine their concerns about life expectancy and side effects into scores rating each potential procedure. With scores derived for each, patients can more easily compare scores and decide.

The author observes that running the model repeatedly for different types of patients yields several observations. Most controversial, he writes, is that external radiation is used too often to treat prostate cancer.

"Although it can provide a moderate reduction in side effects," writes Simon, "its cure rate is lower than many people believe because many articles on radiation treatments for prostate cancer contain a systematic censoring and backdating error."

Among other observations are that surgery usually results in the highest life score for younger men; seed radiation is occasionally more desirable for early stage cancer; and combining low-dose seed radiation and external radiation might be preferable for patients especially concerned about side effects. Confirming general medical practice, the model suggests less aggressive treatment for older patients.

Dr. Simon and colleagues are currently working on an extension of this research that would provide a decision-making tool for men over 40 in the initial stages of prostate screening. Undiagnosed men in this group often have to make successive decisions about whether or not to have a biopsy and how to interpret PSA results.


'/>"/>

Contact: Barry List
barry.list@informs.org
443-794-5182
Institute for Operations Research and the Management Sciences
Source:Eurekalert

Related medicine news :

1. Gerresheimer to be Included in the SDAX Early Decision on Inclusion in the MDAX on September 5, 2007
2. Microarray provides 3 genomic guides to breast cancer treatment decisions
3. Spectranetics to Appeal Decision in Patent Litigation
4. Canadas government funds $1.6M in modern geography to support public health decisions
5. Parents participation in medical decisions linked to self-efficacy
6. Decision-making by residents on-call has miniscule negative impact on patient care
7. Political decisions harming cancer treatment in Europe
8. UniCare Introduces Consumer-Driven Health Products to Give Consumers a Bigger Role in Health Care Decisions
9. Equipping your Sales Force to Influence Hospital Formulary Decision-Makers
10. Newton-Wellesley Hospital First in Massachusetts to Implement Isabel Diagnosis Decision Support System
11. Autism Speaks Applauds Supreme Court Decision Upholding Families Right to Challenge IEPs Without First Trying Out School District Proposed Placement
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop ... The fitness app plans to fix the two major problems leading the fitness industry today:, ... all type program , They don’t eliminate all the reasons people quit their ...
(Date:6/25/2016)... Austin, TX (PRWEB) , ... June 25, 2016 , ... ... Fellow of the American College of Mohs Surgery and to Dr. Russell Peckham for ... popular and highly effective treatment for skin cancer. The selective fellowship in Mohs Micrographic ...
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... ... the United States, named Dr. Sesan Ogunleye, as the Medical Director of its new ... the facility Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, ... at Work award to iHire in recognition of their exemplary accomplishments in worksite health ... annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may ... to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To ... for healthy coping following a traumatic event. , Trauma sufferers tend to feel a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... CAMBRIDGE, Mass. , June 24, 2016 /PRNewswire/ ... the Spaulding Rehabilitation Network,s Dean Center for ... of Physical Medicine and Rehabilitation, MIT Hacking Medicine, ... Center for Innovation, today announced the five finalists ... Hackathon for Lyme disease.  More than 100 scientists, ...
(Date:6/24/2016)... Dehaier Medical Systems Ltd. (NASDAQ: DHRM ) ... medical devices and wearable sleep respiratory products in ... with Hongyuan Supply Chain Management Co., Ltd. (hereinafter referred ... to develop Dehaier,s new Internet medical technology business. ... Hongyuan Supply Chain,s sales platform to reach Dehaier,s dealers ...
(Date:6/24/2016)... , June 24, 2016   Pulmatrix, Inc ., ... developing innovative inhaled drugs, announced today that it was ... Investments reconstituted its comprehensive set of U.S. and ... "This is an important milestone for Pulmatrix," said Chief ... shareholder awareness of our progress in developing drugs for ...
Breaking Medicine Technology: