A systematic review of web-based cancer prognostic calculators: Can they support patient-centered communication with cancer patients?

Introduction: Information about cancer prognosis is a main topic of interest for cancer patients and clinicians alike. Prognostic information can help with decisions about treatment, lessen patients' uncertainty and empower them to participate in the decision making process. Calculating and communicating cancer prognostic information can be challenging due to the high complexity and probabilistic nature of the information. Furthermore, prognostic information is further complicated by the potential interplay between cancer and other comorbid medical conditions. The purpose of this presentation is to present findings from a systematic review of web-based interactive prognostic calculators and assess how they might support patient-centered communication of prognostic information with cancer patients.

Methods: A systematic review of web-based cancer prognostic calculators was conducted using web search engines, peer-reviewed manuscripts, and expert input. Calculators had to be interactive, focus on cancer, available in English, and provide information about probabilities of survival/mortality, recurrence, spread, or clinical response to treatment. Eligible calculators were reviewed and abstracted for content, format, and functions of patient-centered communication and findings were summarized in a tabular format for comparison. The abstraction guide was pilot tested by all abstractors and was refined using a consensus approach.

Summary of Findings: A total of 22 eligible web-based cancer prognostic tools including 95 individual calculators for 88 distinct cancer sites were identified and abstracted. Thirteen of the tools recommended patients as potential direct users; all other tools were designed for clinicians. Outcomes presented will include: 1) general description of calculators, including cancer type, designated users, types of data elements used in prognosis prediction, and validation, 2) calculator interface data entry features, and graphic output, 3) interpretation of prognosis and additional resources, 4) strength and limitations in supporting patient-centered cancer communication about cancer prognosis. Examples from selected calculators will be demonstrated throughout the presentation.