Concordance Study between IBM Watson for Oncology and Real Clinical Practice for Cervical Cancer Patients in China: A Retrospective Analysis
25 Pages Posted: 22 Nov 2018More...
Background: Watson for Oncology (WFO) is a artificial intelligence clinical decision-support systems with evidence-based treatment options for oncologists. WFO has been gradually used in China, but limited reports on whether WFO is suitable for Chinese patients. This study aims to investigate the concordance of treatment options between WFO and real clinical practice at the Second Xiangya Hospital Cancer Center for Cervical cancer patients retrospectively.
Methods: We retrospectively enrolled 300 cases of cervical cancer patients who were hospitalized at the Second Xiangya Hospital Cancer Center from May 2017 to August 2018. WFO provide treatment options for 246 supported cases. Real clinical practice were defined as concordant if treatment options were designated "recommended" or "for consideration" by WFO. Concordance of treatment option between WFO and real clinical practice was analysed statistically.
Findings: Treatment concordance between WFO and real clinical practice occurred in 72.8% (179/246) of cervical cancer cases.Logistic regression analysis showed that rural registration residence [0.64(0.427-0.946), P=0.025], advanced age [0.08(0.03-0.28), P=0.032], poor ECOG performance status [0.29(0.083-1.058), P=0.048], stages II-IV disease ([2.08 (1.002-4.325), P=0.046], [2.09(1.001-4.381), P=0.047], [0.19(0.038-0.91), P=0.025], respectively) have remarkable impact on consistency.Pathological type, differentiation degree, lymphatic and distant metastasis were not found to affect concordance.The main reasons attributed to the 27.2% (67/246) of the discordant cases were the substitution of nedaplatin for cisplatin,reimbursement plan of bevacizumab, surgical preference,and absence of neoadjuvant/adjuvant chemotherapy and PD-1/PD-L1 antibodies recommendations.
Interpretation: WFO recommendations were in 72.8% of concordant with real clinical practice for cervical cancer patients in China. However, several localization and individual factors limit its wider application. So,WFO could be an essential tool but it cannot currently replace oncologists.To be rapidly and fully apply to cervical cancer patients in China, accelerate localization and improvement were needed for WFO.
Funding: This work was supported by the key program of Hunan Provincial Department of
science and technology project (NO.2016JC2048).
Declaration of Interest: None declared.
Ethical Approval: This retrospective study was reviewed and approved by the medical ethics committee of the Second Xiangya Hospital of Central south university (approval number was
Keywords: Artificial intelligence, Watson for Oncology, Cervical cancer, concordance
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