Abstract
Backgrounds/Aims Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the latest evidence and guidelines. However, studies of the concordance rate between WFO and clinicians for advanced gastric cancer (AGC) are lacking. Methods We retrospectively reviewed 65 patients with AGC who consulted WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of the GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment option), and not recommended. Results In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the study. The concordance rate between WFO and the GMDT was 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for consideration level. The main causes of discordance between WFO and the GMDT were as follows. First, WFO did not consider the medical history. Second, WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted to be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended by WFO for financial reasons as they were not covered by medical insurance. Conclusions The concordance rate at the recommended level was relatively low but was higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil Medical Center (GMC) and the Memorial Sloan Kettering Cancer Center (MSKCC), the main WFO consulting center. The utility of WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines.
Highlights
Clinicians who treat patients with advanced gastric cancer (AGC) are challenged to personalize care using the rapidly expanding knowledge base [1]
Among 638 patients with breast cancer treated at Manipal Hospitals in Bangalore, India, a 90% concordance rate was observed between the recommendations of a multidisciplinary team (MDT) and Watson for Oncology (WFO) [9]
We compared the level of agreement between WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in terms of the treatment options recommended to 65 patients with AGC at the Gachon Gil Medical Center (GMC) in Inchon, Korea
Summary
Clinicians who treat patients with advanced gastric cancer (AGC) are challenged to personalize care using the rapidly expanding knowledge base [1]. Cancer-related databases include treatment guidelines and, for example, drug approvals and up-to-date scientific evidence [1]. WFO yielded a high concordance rate and multidisciplinary team approaches in medical oncology, including for breast [4,5,6], colon [7, 8], lung [7], and cervical [9] cancer. Among 638 patients with breast cancer treated at Manipal Hospitals in Bangalore, India, a 90% concordance rate was observed between the recommendations of a multidisciplinary team (MDT) and WFO [9]. WFO has not been validated in terms of the treatment concordance rate compared with multidisciplinary team approaches for patients with AGC, in countries with a high incidence of AGC (e.g., Korea and Japan) [5, 10]. We assessed the level of concordance between WFO and a GMDT for AGC treatment options and evaluated the causes of any discordance as an early, real-world experience in Korea
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