A recent review from researchers at the Kaiser Permanente Colorado Institute for Health Research and the University of Colorado Cancer Center describes the range of online tools that providers and patients can use to inform cancer prognosis and treatment options. (Tools listed at the end of this article.)
“Some simply gave a baseline prognosis for what a patient of certain age and certain comorbidities should expect from diagnosis of a specific kind of cancer. But other tools allowed patients and providers to explore their treatment options, showing the likely benefits of different therapies and in a few cases even dosages,” says Borsika Rabin, PhD, MPH, PharmD, staff researcher at the University of Colorado Cancer Center affiliate Kaiser Permanente Colorado.
The review explores 22 online tools that offer prognoses across 89 types of cancer. The most commonly represented cancers were prostate (11 tools), colorectal (10 tools), breast (8 tools) and melanoma (6 tools).
“What we found was tremendous diversity and variability,” Rabin says. “Some had great, multi-page websites with features including descriptions of how the tools had been extensively validated. Other tools were just one page with no description – you put in numbers and it comes up with a figure.”
Rabin also points out the variability in the audiences for these tools. “Most are meant for providers. They could use these tools to double-check their intuitive prognoses or to give patients a visual representation of likely outcomes with different kinds of therapies. Only 4 of these 22 tools suggested patients themselves as potential users.”
The review will inform the design and dissemination of a similar online prognostic tool in development by the National Cancer Institute.
“There is a push from patient advocates to make these tools more usable and available to the public. This could help patients evaluate their own treatment options outside the doctor or specialist visit,” Rabin says.
Currently this same research group is developing a website that provides guidance on existing tools and their compares their characteristics. The website will be released by early October.
Until then, providers interested in exploring information about prognosis can visit the following tools: Adjuvant Online, AJCC Individualized Melanoma Patient, Outcome Prediction Tools, Artificial Neural Networks in Prostate Cancer, Recurrence-free Survival, CancerMath, UCSF Capra Score, Cancer Survival Query System, Disease free survival calculator, FinProg Online, Nomograms for predicting survival of GBM patients, The Han tables, IBTR – Breast Cancer Module Version, Knight Cancer Institute Survival Prediction Tools, Lerner Research Institute Risk Calculators, MAASTRO prediction website, MD Anderson Clinical calculators, Memorial Sloan-Kettering Prediction Tools, University of Montreal – Nomograms, Mayo Clinic Adjuvant Tool, Prognostigram, QxMD – Calculate.
This work was supported by the National Cancer Institute (P20 CA137219).