A Clinical Decision Support Tool To Predict Survival in Cancer Patients beyond 120 Days after Palliative Chemotherapy.

Background: Palliative chemotherapy is often administered to terminally ill cancer patients to relieve symptoms. Yet, unnecessary use of chemotherapy can worsen patients' quality of life due to treatment-related toxicities. Thus, accurate prediction of survival in terminally ill patients can help cl...

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Publicado en:Journal of Palliative Medicine Vol. 15; no. 8; pp. 863 - 870
Autores principales: Ng, Terence, Chew, Lita, Yap, Chun Wei
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Aug2012
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2012
      vid: 15
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      pub: Mary Ann Liebert, Inc.
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        atl: A Clinical Decision Support Tool To Predict Survival in Cancer Patients beyond 120 Days after Palliative Chemotherapy.
      aug:
        au:
          Ng, Terence
          Chew, Lita
          Yap, Chun Wei
        affil: Department of Pharmacy, National University of Singapore, Singapore.
      sug:
        subj:
          Decision Support Systems, Clinical
          Cancer Patients
          Palliative Care
          Survival
          Chemotherapy, Cancer
          Prognosis
          Quality of Life
          Human
          Singapore
          Algorithms Classification
          Sensitivity and Specificity
          Data Mining
          Random Sample
          Retrospective Design
          Descriptive Statistics
          Neural Networks (Computer)
          Data Analysis Software
          Serum Albumin
          Funding Source
      ab: Background: Palliative chemotherapy is often administered to terminally ill cancer patients to relieve symptoms. Yet, unnecessary use of chemotherapy can worsen patients' quality of life due to treatment-related toxicities. Thus, accurate prediction of survival in terminally ill patients can help clinicians decide on the most appropriate palliative care for these patients. However, studies have shown that clinicians often make imprecise predictions of survival in cancer patients. Hence, the purpose of this study was to create a clinical decision support tool to predict survival in cancer patients beyond 120 days after palliative chemotherapy. Materials and Methods: Data were obtained from a retrospective study of 400 randomly selected terminally ill cancer patients in the National Cancer Centre Singapore (NCCS) from 2008 to 2009. After removing patients with missing data, there were 325 patients remaining for model development. Three classification algorithms, naive Bayes (NB), neural network (NN), and support vector machine (SVM) were used to create the models. A final model with the best prediction performance was then selected to develop the tool. Results: The NN model had the best prediction performance. The accuracy, specificity, sensitivity, and area under the curve (AUC) of this model were 78%, 82%, 74%, and 0.857, respectively. Five patient attributes (albumin level, alanine transaminase level (ATL), absolute neutrophil count, Eastern Cooperative Oncology Group (ECOG) status, and number of metastatic sites) were included in the model. Conclusions: A decision support tool to predict survival in cancer patients beyond 120 days after palliative chemotherapy was created. With further validation, this tool coupled with the professional judgment of clinicians can help improve patient care.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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