The Use of Decision Analytic Models to Inform Clinical Decision Making in the Management of Hepatocellular Carcinoma

2005 ◽  
Vol 9 (2) ◽  
pp. 225-234
Author(s):  
W. Ray Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Analytic Models

scholarly journals Clinical decision making and research in hepatocellular carcinoma: Pivotal role of imaging techniques

Hepatology ◽  
2011 ◽  
Vol 54 (6) ◽  
pp. 2238-2244 ◽  
Author(s):  
Jordi Bruix ◽  
Maria Reig ◽  
Jordi Rimola ◽  
Alejandro Forner ◽  
Marta Burrel ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Imaging Techniques ◽  
Clinical Decision ◽  
Pivotal Role

Choice of Intra-arterial Therapy for Hepatocellular Carcinoma: Evidence and Future Horizons

2017 ◽  
Vol 01 (02) ◽  
pp. 105-114 ◽  
Author(s):  
Mansur Ghani ◽  
Vinayak Thakur ◽  
Jean-François Geschwind
Keyword(s):  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Kinase Inhibitor ◽  
Transarterial Embolization ◽  
Clinical Decision ◽  
The United States ◽  
Surrounding Tissue ◽  
Western World ◽  
Antiangiogenic Agents

AbstractHepatocellular carcinoma is the second most common cause of cancer-related deaths worldwide. Along with viral and alcoholic hepatitis, obesity is the leading cause for increasing incidence in the western world, specifically in the United States. As most patients initially present with intermediate to advanced stage disease, curative therapies such as ablation, surgical resection, or liver transplantation cannot usually be applied. Thus, intra-arterial therapies (IATs), such as transarterial chemoembolization (TACE), have become a mainstay of treatment. Several variations of transarterial embolotherapy, such as bland transarterial embolization or drug-eluting bead TACE, are currently available and used in clinical practice. Yttrium-90 radioembolization is a distinct IAT that relies on delivery of radiation to surrounding tissue for tumor death. However, no clear guidelines or evidence exist that would favor one of these options over the other, leaving the decision-making process open to influence by local expertise and experience. In addition, combining TACE with systemic antiangiogenic agents, such as the multityrosine kinase inhibitor sorafenib, has been investigated in several prospective clinical trials without clearly demonstrating substantial survival benefits of the combination over TACE alone. This review will summarize and discuss the available clinical evidence and indications for each treatment modality with the goal of facilitating clinical decision-making processes, and provide an overview of the ongoing efforts to compare different IAT modalities.

Clinical Decision-Making by Gastroenterologists and Hepatologists for Patients with Early Hepatocellular Carcinoma

2014 ◽  
Vol 21 (6) ◽  
pp. 1844-1851 ◽  
Author(s):  
Hari Nathan ◽  
H. Franklin Herlong ◽  
Ahmet Gurakar ◽  
Zhiping Li ◽  
Ayman A. Koteish ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Hepatocellular Carcinoma

Can artificial intelligence support the clinical decision making for Barcelona clinic liver cancer stage 0/a hepatocellular carcinoma in China?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15634-e15634
Author(s):  
Ze-bin Chen ◽  
Shu-Ling Chen ◽  
Rui-Ming Liang ◽  
Zhen-Wei Peng ◽  
Jing-Xian Shen ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Clinical Decision Support System ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Concordance Rate ◽  
Chinese Patients ◽  
Cancer Types ◽  
Ibm Watson

e15634 Background: Artificial intelligence (AI) is emerging as a revolutionary technology with the power to transform healthcare. IBM Watson for Oncology (WFO), as an AI clinical decision support system (CDSS), has been investigated about its impact on clinical decision making in some cancer types and shown potential to be an effective CDSS in cancer care. However, the feasibility of WFO in Chinese patients with hepatocellular carcinoma (HCC) has not been reported. Methods: Artificial intelligence (AI) is emerging as a revolutionary technology with the power to transform healthcare. IBM Watson for Oncology (WFO), as an AI clinical decision support system (CDSS), has been investigated about its impact on clinical decision making in some cancer types and shown potential to be an effective CDSS in cancer care. However, the feasibility of WFO in Chinese patients with hepatocellular carcinoma (HCC) has not been reported. Results: The overall concordance rate was 60.5%, with 53.7% and 61.4% in BCLC stage 0 and A respectively. After the MDT re-review, the overall, BCLC stage 0 and A concordance rate increased to 67.3%, 65.9% and 67.3%. The main discordance was that MDT recommended more aggressive treatment options (eg. hepatectomy) than WFO did. The increase in concordance rate may be due to the progress of treatment of HCC in the past 5 years. Conclusions: With the concordance and reasonability verified by MDT in this study, WFO may provide practical reference in BCLC stage 0/A HCC. Localization is required to cover the disparity in guideline and patient characteristics between China and the US.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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