Abstract
BackgroundWatson for Oncology (WFO) is a cognitive computing system that provides clinical decision support. This study examined the concordance between the treatment recommendations for colorectal cancer (CRC) proposed by WFO and those recommended by the multidisciplinary teams (MDTs), and evaluated the influence of concordance on the prognosis.MethodsWe retrospectively collected 175 patients with colorectal cancer who received treatment recommended by MDTs at a hospital in China, and evaluated them using WFO. Concordance between the two recommendations was analyzed. The overall survival was analyzed between concordant and non-concordant groups. Logistic regression analyses were performed and a concordance-predicting model was developed.ResultsConcordance between WFO’ and MDTs’ recommendations occurred in 66.9% (117/175) of cases. The overall survival (OS) was significantly better in concordant group and non-concordance was found to be an independent prognostic factor [hazard ratio (HR)=2.784 (95% CI 1.264–6.315)]. Logistic regression analyses determined that tumor type [odds ratio (OR)= 2.195 for left colon cancer and OR=2.502 for rectum cancer], and TNM stage (OR=0.545 for stage II, OR=0.187 for stage III, OR=0.127 for stage IV) were independently related with concordance, which were used to develop a concordance-predictive-nomogram.ConclusionsTreatment recommendations for patients with colorectal cancer determined by WFO and MDTs were mostly concordant. However, the survival was better among concordant patients and non-concordance was found to be an independent prognostic factor. This study presents a nomogram that can be conveniently used for predicting individualized concordance. However, our findings should be prospectively validated in multi-center trials.
Highlights
Colorectal cancer (CRC) is the third most common cancer in males, and the second most common cancer in females according to global cancer statistics [1]
To the best of our knowledge, this is the first study that examined the concordance between the treatment regimens used by multidisciplinary teams (MDTs) and those recommended by Watson for Oncology (WFO) as well as the survival impact of concordance in patients with colorectal cancer
We found that the overall concordance between the therapeutic recommendations of WFO and the regimens used by MDTs were 66.9%
Summary
Colorectal cancer (CRC) is the third most common cancer in males, and the second most common cancer in females according to global cancer statistics [1]. Chemotherapy options for patients with colorectal cancer are determined by multidisciplinary teams (MDTs), based on the National Comprehensive Cancer Network (NCCN) guidelines, combined with clinical experience and findings of recent studies. Considering the contradiction between the need for individualized treatment plans for every patient, and the greatly imbalanced distribution of medical resources, as well as the inconvenience of organizing MDT discussions, a tool that can assist practitioners to quickly provide accurate treatment recommendations and learn the new developments of the field in a more efficient manner is urgently needed. Somashekhar et al [10] reported that the treatment concordance between WFO and multidisciplinary tumor board occurred in 93% of 638 breast cancer cases, suggesting that the AI clinical decision support system may be a helpful tool for treatment-related decision-making in breast cancer. This study examined the concordance between the treatment recommendations for colorectal cancer (CRC) proposed by WFO and those recommended by the multidisciplinary teams (MDTs), and evaluated the influence of concordance on the prognosis
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