267416 A systematic review of web-based cancer prognostic calculators: Can they support patient-centered communication with cancer patients?

Tuesday, October 30, 2012 : 3:10 PM - 3:30 PM

Borsika A. Rabin, PhD, MPH , CRN Cancer Communication Research Center, Kaiser Permanente Colorado, Denver, CO
Bridget Gaglio, PhD, MPH , Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, MD
Tristan J. Sanders , Institute for Health Research, Kaiser Permanente, Denver, CO
Larissa Nekhlyudov, MD, MPH , Department of Population Medicine, Harvard Medical School and Department of Medicine, Harvard Vanguard Medical Associates, Boston, MA
Alfred Marcus, PhD , University of Colorado Downtown and Health Sciences Center, Aurora, CO
Sheana Bull, PhD, MPH , Community and Behavioral Health, Colorado School of Public Health, Aurora, CO
James W. Dearing, PhD , CRN Cancer Communication Research Center, Kaiser Permanente Colorado, Denver, CO, Algeria
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.

Learning Areas:
Chronic disease management and prevention
Communication and informatics
Provision of health care to the public

Learning Objectives:
1. Describe and compare the content and format of existing interactive web-based cancer prognostic calculators. 2. Discuss how interactive web-based cancer prognostic calculators might support patient-centered communication of prognosis to cancer patients. 3. Identify areas were the calculators are (and are not) meeting core patient-centered communication functions.

Keywords: Cancer, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized teh systematic review, participated in the abstraction of tools and led the analysis of data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.