JCO Clinical Cancer Informatics最新文献

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Developing and Validating an Automatic Support System for Tumor Coding in Pathology Reports in Spanish.
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-02-01 Epub Date: 2025-02-24 DOI: 10.1200/CCI.24.00124
Fabián Villena, Pablo Báez, Sergio Peñafiel, Matías Rojas, Inti Paredes, Jocelyn Dunstan
{"title":"Developing and Validating an Automatic Support System for Tumor Coding in Pathology Reports in Spanish.","authors":"Fabián Villena, Pablo Báez, Sergio Peñafiel, Matías Rojas, Inti Paredes, Jocelyn Dunstan","doi":"10.1200/CCI.24.00124","DOIUrl":"10.1200/CCI.24.00124","url":null,"abstract":"<p><strong>Purpose: </strong>Pathology reports provide valuable information for cancer registries to understand, plan, and implement strategies to mitigate the impact of cancer. However, coding essential information from unstructured reports is performed by experts in a time-consuming manual process. We developed and validated a novel two-step automatic coding system that first recognizes tumor morphology and topography mentions from free text and then suggests codes from the International Classification of Diseases for Oncology (ICD-O) in Spanish.</p><p><strong>Materials and methods: </strong>We created an annotated corpus of tumor morphology and topography mentions consisting of 1,101 documents. We combined it with the CANTEMIST corpus (Cancer Text Mining Shared Task). Specifically, we implemented a named entity recognition (NER) model using the bidirectional long short-term memory network-conditional random field architecture enhanced with a stacked embedding layer. We applied transfer learning from state-of-the-art pretrained language models to obtain high-quality contextual representations, thus improving the detection of entities. The mentions found using this model were subsequently coded using a search engine tailored to the ICD-O codes.</p><p><strong>Results: </strong>Our NER models achieved an F1 score of 0.86 and 0.90 for tumor morphology and topography, respectively. The overall performance of our automatic coding system achieved an accuracy at five suggestions of 0.72 and 0.65 for tumor morphology and topography, respectively.</p><p><strong>Conclusion: </strong>These results demonstrate the feasibility of implementing natural language processing tools in the routine of a cancer center to extract and code valuable information from pathology reports. Our recommender system allows reliable and transparent coding at the moment of consultation. This publication shares the annotated corpus in Spanish, annotation guidelines, and source code to reproduce our experiments.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400124"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Validation of Clinical Dynamic Contrast-Enhanced Magnetic Resonance Imaging Perfusion Modeling and Neoadjuvant Chemotherapy Response Prediction in Breast Cancer Using 18FDG and 64Cu-DOTA-Trastuzumab Positron Emission Tomography Studies. 使用18FDG和64cu - dota -曲妥珠单抗正电子发射断层扫描研究验证临床动态磁共振成像灌注建模和乳腺癌新辅助化疗反应预测。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-14 DOI: 10.1200/CCI.23.00248
John Whitman, Vikram Adhikarla, Lusine Tumyan, Joanne Mortimer, Wei Huang, Russell Rockne, Joesph R Peterson, John Cole
{"title":"Validation of Clinical Dynamic Contrast-Enhanced Magnetic Resonance Imaging Perfusion Modeling and Neoadjuvant Chemotherapy Response Prediction in Breast Cancer Using <sup>18</sup>FDG and <sup>64</sup>Cu-DOTA-Trastuzumab Positron Emission Tomography Studies.","authors":"John Whitman, Vikram Adhikarla, Lusine Tumyan, Joanne Mortimer, Wei Huang, Russell Rockne, Joesph R Peterson, John Cole","doi":"10.1200/CCI.23.00248","DOIUrl":"10.1200/CCI.23.00248","url":null,"abstract":"<p><strong>Purpose: </strong>Perfusion modeling presents significant opportunities for imaging biomarker development in breast cancer but has historically been held back by the need for data beyond the clinical standard of care (SoC) and uncertainty in the interpretability of results. We aimed to design a perfusion model applicable to breast cancer SoC dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) series with results stable to low temporal resolution imaging, comparable with published results using full-resolution DCE-MRI, and correlative with orthogonal imaging modalities indicative of biophysical markers.</p><p><strong>Methods: </strong>Subsampled high-temporal-resolution DCE-MRI series were run through our perfusion model and resulting fits were compared for consistency. The fits were also compared against previously published results from institutions using the full resolution series. The model was then evaluated on a separate cohort for validity of biomarker indications. Finally, the model was used as a fundamental part of predicting response to neoadjuvant chemotherapy (NACT).</p><p><strong>Results: </strong>Temporally subsampled DCE-MRI series yield perfusion fit variations on the scale of 1% of the tumor median value when input frames are varied. Fits generated from pseudoclinical series are within the variation range seen between imaging sites (ρ = 0.55), voxel-wise. The model also demonstrates significant correlations with orthogonal positron emission tomography imaging, indicating potential for use as a biomarker proxy. Specifically, using the perfusion fits as the grounding for a biophysical simulation of response, we correctly predict the pathologic complete response status after NACT in 15 of 18 patients, for an accuracy of 0.83, with a specificity and sensitivity of 0.83 as well.</p><p><strong>Conclusion: </strong>Clinical DCE-MRI data may be leveraged to provide stable perfusion fit results and indirectly interrogate the tumor microenvironment. These fits can then be used downstream for prediction of response to NACT with high accuracy.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2300248"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ImpACT Project: Improving Access to Clinical Trials in Victoria, an Artificial Intelligence-Based Approach. 影响项目:改善获得临床试验在维多利亚州,人工智能为基础的方法。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-09 DOI: 10.1200/CCI.24.00137
Maria L Bechelli, Kris Ivanova, Suan Siang Tan, Beena Kumar, Dayna Swiatek, Surein Arulananda, Sue M Evans
{"title":"ImpACT Project: Improving Access to Clinical Trials in Victoria, an Artificial Intelligence-Based Approach.","authors":"Maria L Bechelli, Kris Ivanova, Suan Siang Tan, Beena Kumar, Dayna Swiatek, Surein Arulananda, Sue M Evans","doi":"10.1200/CCI.24.00137","DOIUrl":"10.1200/CCI.24.00137","url":null,"abstract":"<p><strong>Purpose: </strong>Enhancing the speed and efficiency of clinical trial recruitment is a key objective across international health systems. This study aimed to use artificial intelligence (AI) applied in the Victorian Cancer Registry (VCR), a population-based cancer registry, to assess (1) if VCR received all relevant pathology reports for three clinical trials, (2) AI accuracy in auto-extracting information from pathology reports for recruitment, and (3) the number of participants approached for trial enrollment using the AI approach compared with standard hospital-based recruitment.</p><p><strong>Methods: </strong>To verify pathology report accessibility for VCR trial enrollment, reports from the laboratory were cross-referenced. To determine the accuracy of a Rapid Case Ascertainment (RCA) module of the AI software in extracting key clinical variables from the pathology report, data were compared with manually reviewed reports. To examine the effectiveness of the AI recruitment approach, the number of patients approached for recruitment was compared with standard practice.</p><p><strong>Results: </strong>Of the 195 reports provided by the pathology laboratory, 185 (94.9%) were received by VCR, 73 of 195 (37.4%) were eligible for the studies, and 5 of 73 (6.8%) eligible cases had not been received by the VCR. The RCA module demonstrated an accuracy of 93% and an F1 score of 0.94 in extracting key clinical variables. However, the RCA false-positive rate was 10% and the false-negative rate was 5%. The standard hospital approach selected fewer cases for approach to clinical trials compared with the RCA module approach, 8 of 336 (2.4%) versus 12 of 336 (3.6%), respectively.</p><p><strong>Conclusion: </strong>Using AI to screen potentially eligible cases for recruitment to three clinical trials resulted in a 50% increase in eligible cases being approached for enrollment.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400137"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erratum: Volumetric Breast Density Estimation From Three-Dimensional Reconstructed Digital Breast Tomosynthesis Images Using Deep Learning. 勘误:使用深度学习的三维重建数字乳房断层合成图像的体积乳房密度估计。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-14 DOI: 10.1200/CCI-24-00325
{"title":"Erratum: Volumetric Breast Density Estimation From Three-Dimensional Reconstructed Digital Breast Tomosynthesis Images Using Deep Learning.","authors":"","doi":"10.1200/CCI-24-00325","DOIUrl":"https://doi.org/10.1200/CCI-24-00325","url":null,"abstract":"","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400325"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delta-Radiomics Using Machine Learning Classifiers With Auxiliary Data Sets to Predict Disease Progression During Magnetic Resonance-Guided Radiotherapy in Adrenal Metastases.
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.1200/CCI.24.00002
Jesutofunmi A Fajemisin, John M Bryant, Payman G Saghand, Matthew N Mills, Kujtim Latifi, Eduardo G Moros, Vladimir Feygelman, Jessica M Frakes, Sarah E Hoffe, Kathryn E Mittauer, Tugce Kutuk, Rupesh Kotecha, Issam El Naqa, Stephen A Rosenberg
{"title":"Delta-Radiomics Using Machine Learning Classifiers With Auxiliary Data Sets to Predict Disease Progression During Magnetic Resonance-Guided Radiotherapy in Adrenal Metastases.","authors":"Jesutofunmi A Fajemisin, John M Bryant, Payman G Saghand, Matthew N Mills, Kujtim Latifi, Eduardo G Moros, Vladimir Feygelman, Jessica M Frakes, Sarah E Hoffe, Kathryn E Mittauer, Tugce Kutuk, Rupesh Kotecha, Issam El Naqa, Stephen A Rosenberg","doi":"10.1200/CCI.24.00002","DOIUrl":"https://doi.org/10.1200/CCI.24.00002","url":null,"abstract":"<p><strong>Purpose: </strong>Adaptive radiotherapy accounts for interfractional anatomic changes. We hypothesize that changes in the gross tumor volumes identified during daily scans could be analyzed using delta-radiomics to predict disease progression events. We evaluated whether an auxiliary data set could improve prediction performance.</p><p><strong>Materials and methods: </strong>We analyzed 108 patients (n = 90 internal; n = 18 external) who received ablative radiotherapy. The internal data set included 42 patients with adrenal cancer, 23 patients with lung cancer, and 25 patients with pancreatic cancer, with the clinical end point of progression-free survival events. The median dose was 50 Gy, which was delivered over five fractions. The delta features are the ratio of the features of the last to first treatment fraction, F5/F1, and the concatenation of the first and last fraction features, F1||F5. Decision tree classifier with and without auxiliary data sets, and the external data set was used exclusively for independent testing of the final models.</p><p><strong>Results: </strong>During internal training, for the F1||F5 model, the inclusion of the lung data set increased our AUC receiver operator characteristic curve (ROC) from 0.53 ± 0.12 to 0.61 ± 0.11, whereas the pancreatic data set increased our AUC-ROC to 0.60 ± 0.14. For the F5/F1 model, the inclusion of the lung auxiliary data increased our AUC-ROC from 0.52 ± 0.13 to 0.65 ± 0.11, whereas it modestly changed by 0.62 ± 0.13 with the pancreas. During external testing, for the F5/F1 model, we reported an AUC-ROC of 0.60 with the lung auxiliary data and 0.43 with the pancreatic data. Also, for the F5||F1 model, we reported an AUC-ROC of 0.70 with the lung auxiliary and 0.60 with the pancreatic data.</p><p><strong>Conclusion: </strong>Decision trees provided an explainable model on the external data set. The validation of our model on an external data set may be the first step to biologically adapted radiotherapy recognizing radiomics signals for potential recurrence.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400002"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating Cancer Screening in the Era of Advanced Causal Inference Methods: Innovation, Adherence, and Health Equity Considerations. 在先进的因果推理方法时代评估癌症筛查:创新、坚持和健康公平考虑。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-10 DOI: 10.1200/CCI-24-00214
Rebecca A Miksad, Somnath Sarkar
{"title":"Evaluating Cancer Screening in the Era of Advanced Causal Inference Methods: Innovation, Adherence, and Health Equity Considerations.","authors":"Rebecca A Miksad, Somnath Sarkar","doi":"10.1200/CCI-24-00214","DOIUrl":"https://doi.org/10.1200/CCI-24-00214","url":null,"abstract":"","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400214"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and Validation of Emoji Response Scales for Assessing Patient-Reported Outcomes. 用于评估患者报告结果的表情符号反应量表的开发和验证。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-07 DOI: 10.1200/CCI-24-00148
Carrie A Thompson, Paul J Novotny, Kathleen Yost, Alicia C Bartz, Lauren Rogak, Amylou C Dueck
{"title":"Development and Validation of Emoji Response Scales for Assessing Patient-Reported Outcomes.","authors":"Carrie A Thompson, Paul J Novotny, Kathleen Yost, Alicia C Bartz, Lauren Rogak, Amylou C Dueck","doi":"10.1200/CCI-24-00148","DOIUrl":"https://doi.org/10.1200/CCI-24-00148","url":null,"abstract":"<p><strong>Purpose: </strong>Emoji are digital images or icons used to express an idea or emotion in electronic communication. The purpose of this study was to develop and evaluate the psychometric properties of two patient-reported scales that incorporate emoji.</p><p><strong>Methods: </strong>The Emoji Response Scale developed for this study has two parts: the Emoji-Ordinal and Emoji-Mood scales. A pilot study was designed to validate the ordinal nature of the Emoji-Ordinal Scale. Twenty patients were shown all possible pairs of five emoji and asked to select the most positive from each pair. The psychometric ordering was assessed using Coombs unfolding and Thurstone scaling. A separate pilot study was designed to determine which emoji to include in the Emoji-Mood Scale. Ten common feelings experienced by patients with cancer were chosen by the study team. Patients and providers were asked to select the one emoji that best represented each feeling from the selection. The most commonly selected emotions and representative emoji were chosen for the Emoji-Mood Scale. In a randomized study of 294 patients, Spearman correlations, Wilcoxon tests, and Bland-Altman analyses determined the construct validity of the scales compared with Linear Analog Scale Assessments (LASA) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores.</p><p><strong>Results: </strong>Ninety-five percent of patients selected the same ordering among the ordinal emoji, and Thurstone scaling confirmed the ordinal nature of the response scale. The construct validity of the scales was high with correlations between the Emoji-Ordinal Scale and the LASA scale of 0.70 for emotional well-being, 0.72 for physical well-being, 0.74 for overall quality of life, and -0.81 for fatigue. Emoji-Mood Scale ratings were strongly related to PROMIS global mental, global physical, fatigue, anxiety, sleep disturbance, and social activity scales (<i>P</i> < .0001).</p><p><strong>Conclusion: </strong>This study provides evidence that scales incorporating emoji are valid for collecting patient-reported outcomes.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400148"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility and Acceptability of Collecting Passive Smartphone Data for Potential Use in Digital Phenotyping Among Family Caregivers and Patients With Advanced Cancer. 收集被动智能手机数据用于家庭护理人员和晚期癌症患者数字表型分析的可行性和可接受性。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-02 DOI: 10.1200/CCI-24-00201
J Nicholas Odom, Kyungmi Lee, Erin R Currie, Kristen Allen-Watts, Erin R Harrell, Avery C Bechthold, Sally Engler, Kayleigh Curry, Arif H Kamal, Christine S Ritchie, George Demiris, Alexi A Wright, Marie A Bakitas, Andres Azuero
{"title":"Feasibility and Acceptability of Collecting Passive Smartphone Data for Potential Use in Digital Phenotyping Among Family Caregivers and Patients With Advanced Cancer.","authors":"J Nicholas Odom, Kyungmi Lee, Erin R Currie, Kristen Allen-Watts, Erin R Harrell, Avery C Bechthold, Sally Engler, Kayleigh Curry, Arif H Kamal, Christine S Ritchie, George Demiris, Alexi A Wright, Marie A Bakitas, Andres Azuero","doi":"10.1200/CCI-24-00201","DOIUrl":"10.1200/CCI-24-00201","url":null,"abstract":"<p><strong>Purpose: </strong>Modeling passively collected smartphone sensor data (called digital phenotyping) has the potential to detect distress among family caregivers and patients with advanced cancer and could lead to novel clinical models of cancer care. The purpose of this study was to assess the feasibility and acceptability of collecting passive smartphone data from family caregivers and their care recipients with advanced cancer over 24 weeks.</p><p><strong>Methods: </strong>This was an observational feasibility study. Family caregivers and patients with advanced cancer were recruited through clinic or via social media and downloaded a digital phenotyping application (Beiwe) to their smartphones that passively collected sensor data over 24 weeks. Feasibility was evaluated by quantifying enrollment and retention and the quantity of acquired data. Acceptability was assessed through post-24 week qualitative interviews.</p><p><strong>Results: </strong>Of 178 caregiver and patient dyads approached, 22.5% of caregivers (n = 40) and 10.1% of patients (n = 18) both consented to the study and successfully downloaded the application, with most recruited through social media (93%). Of 24 weeks (168 days), the median number of days that data were received was 141 days. Interviews yielded three themes: (1) experiences with study procedures were generally positive despite some technical challenges; (2) security and privacy concerns were minimal, mitigated by clear explanations, trust in the health care system, and privacy norms; and (3) a clinical model that used passive smartphone monitoring to automatically trigger assistance could be beneficial but with concern about false alarms.</p><p><strong>Conclusion: </strong>This pilot study of collecting passive smartphone data found mixed indicators of feasibility, with suboptimal enrollment rates, particularly via clinic, but positive retention and data collection rates for those who did enroll. Participants had generally positive views of passive monitoring.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400201"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Explainable Machine Learning to Predict Treatment Response in Advanced Non-Small Cell Lung Cancer. 可解释的机器学习预测晚期非小细胞肺癌的治疗反应。
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-03 DOI: 10.1200/CCI-24-00157
Vinayak S Ahluwalia, Ravi B Parikh
{"title":"Explainable Machine Learning to Predict Treatment Response in Advanced Non-Small Cell Lung Cancer.","authors":"Vinayak S Ahluwalia, Ravi B Parikh","doi":"10.1200/CCI-24-00157","DOIUrl":"10.1200/CCI-24-00157","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint inhibitors (ICIs) have demonstrated promise in the treatment of various cancers. Single-drug ICI therapy (immuno-oncology [IO] monotherapy) that targets PD-L1 is the standard of care in patients with advanced non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50%. We sought to find out if a machine learning (ML) algorithm can perform better as a predictive biomarker than PD-L1 alone.</p><p><strong>Methods: </strong>Using a real-world, nationwide electronic health record-derived deidentified database of 38,048 patients with advanced NSCLC, we trained binary prediction algorithms to predict likelihood of 12-month progression-free survival (PFS; 12-month PFS) and 12-month overall survival (OS; 12-month OS) from initiation of first-line therapy. We evaluated the algorithms by calculating the AUC on the test set. We plotted Kaplan-Meier curves and fit Cox survival models comparing survival between patients who were classified as low-risk (LR) for 12-month disease progression or 12-month mortality versus those classified as high-risk.</p><p><strong>Results: </strong>The ML algorithms achieved an AUC of 0.701 (95% CI, 0.689 to 0.714) and 0.718 (95% CI, 0.707 to 0.730) for 12-month PFS and 12-month OS, respectively. Patients in the LR group had lower 12-month disease progression (hazard ratio [HR], 0.47 [95% CI, 0.45 to 0.50]; <i>P</i> < .001) and 12-month all-cause mortality (HR, 0.31 [95% CI, 0.29 to 0.34]; <i>P</i> < .0001) compared with the high-risk group. Patients deemed LR for disease progression and mortality on IO monotherapy were less likely to progress (HR, 0.53 [95% CI, 0.46 to 0.61]; <i>P</i> < .0001) or die (HR, 0.30 [95% CI, 0.24 to 0.37]; <i>P</i> < .001) compared with the high-risk group.</p><p><strong>Conclusion: </strong>An ML algorithm can more accurately predict response to first-line therapy, including IO monotherapy, in patients with advanced NSCLC, compared with PD-L1 alone. ML may better aid clinical decision making in oncology than a single biomarker.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400157"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Provision of Radiology Reports Simplified With Large Language Models to Patients With Cancer: Impact on Patient Satisfaction.
IF 3.3
JCO Clinical Cancer Informatics Pub Date : 2025-01-01 Epub Date: 2025-01-29 DOI: 10.1200/CCI-24-00166
Amit Gupta, Swarndeep Singh, Hema Malhotra, Himanshu Pruthi, Aparna Sharma, Amit K Garg, Mukesh Yadav, Devasenathipathy Kandasamy, Atul Batra, Krithika Rangarajan
{"title":"Provision of Radiology Reports Simplified With Large Language Models to Patients With Cancer: Impact on Patient Satisfaction.","authors":"Amit Gupta, Swarndeep Singh, Hema Malhotra, Himanshu Pruthi, Aparna Sharma, Amit K Garg, Mukesh Yadav, Devasenathipathy Kandasamy, Atul Batra, Krithika Rangarajan","doi":"10.1200/CCI-24-00166","DOIUrl":"https://doi.org/10.1200/CCI-24-00166","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the perceived utility and effect of simplified radiology reports on oncology patients' knowledge and feasibility of large language models (LLMs) to generate such reports.</p><p><strong>Materials and methods: </strong>This study was approved by the Institute Ethics Committee. In phase I, five state-of-the-art LLMs (Generative Pre-Trained Transformer-4o [GPT-4o], Google Gemini, Claude Opus, Llama-3.1-8B, and Phi-3.5-mini) were tested to simplify 50 oncology computed tomography (CT) report impressions using five distinct prompts with each LLM. The outputs were evaluated quantitatively using readability indices. Five LLM-prompt combinations with best average readability scores were also assessed qualitatively, and the best LLM-prompt combination was selected. In phase II, 100 consecutive oncology patients were randomly assigned into two groups: original report (received original report impression) and simplified report (received LLM-generated simplified versions of their CT report impressions under the supervision of a radiologist). A questionnaire assessed the impact of these reports on patients' knowledge and perceived utility.</p><p><strong>Results: </strong>In phase I, Claude Opus-Prompt 3 (explain to a 15-year-old) performed slightly better than other LLMs, although scores for GPT-4o, Gemini, Claude Opus, and Llama-3.1 were not significantly different (<i>P</i> > .0033 on Wilcoxon signed-rank test with Bonferroni correction). In phase II, simplified report group patients demonstrated significantly better knowledge of primary site and extent of their disease as well as showed significantly higher confidence and understanding of the report (<i>P</i> < .05 for all). Only three (of 50) simplified reports required corrections by the radiologist.</p><p><strong>Conclusion: </strong>Simplified radiology reports significantly enhanced patients' understanding and confidence in comprehending their medical condition. LLMs performed very well at this simplification task; therefore, they can be potentially used for this purpose, although there remains a need for human oversight.</p>","PeriodicalId":51626,"journal":{"name":"JCO Clinical Cancer Informatics","volume":"9 ","pages":"e2400166"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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