There are a couple of takes on this.
One is like “big data and data analytics supplanting doctors.”
So Dr. Cary Oberije certainly knows how to gain popularity with conventional-minded doctors.
In Mathematical Models Out-Perform Doctors in Predicting Cancer Patients’ Responses to Treatment she reports on research showing predictive models are better than doctors at predicting the outcomes and responses of lung cancer patients to treatment… “The number of treatment options available for lung cancer patients are increasing, as well as the amount of information available to the individual patient. It is evident that this will complicate the task of the doctor in the future,” said the presenter, Dr Cary Oberije, a postdoctoral researcher at the MAASTRO Clinic, Maastricht University Medical Center, Maastricht, The Netherlands. “If models based on patient, tumor and treatment characteristics already out-perform the doctors, then it is unethical to make treatment decisions based solely on the doctors’ opinions. We believe models should be implemented in clinical practice to guide decisions.”
Dr Oberije says,
“Correct prediction of outcomes is important for several reasons… First, it offers the possibility to discuss treatment options with patients. If survival chances are very low, some patients might opt for a less aggressive treatment with fewer side-effects and better quality of life. Second, it could be used to assess which patients are eligible for a specific clinical trial. Third, correct predictions make it possible to improve and optimise the treatment. Currently, treatment guidelines are applied to the whole lung cancer population, but we know that some patients are cured while others are not and some patients suffer from severe side-effects while others don’t. We know that there are many factors that play a role in the prognosis of patients and prediction models can combine them all.”
At present, prediction models are not used as widely as they could be by doctors…. some models lack clinical credibility; others have not yet been tested; the models need to be available and easy to use by doctors; and many doctors still think that seeing a patient gives them information that cannot be captured in a model.
Dr. Oberije asserts, Our study shows that it is very unlikely that a doctor can outperform a model.
Along the same lines, mathematical models also have been deployed to predict erectile dysfunction after prostate cancer.
I think Dr. Oberije is probably right that physicians could do well to avail themselves of broader medical databases – on prostate conditions, for example – rather than sort of shooting from the hip with each patient.
The other approach is “teamwork between physicians, data and other analysts should be the goal.”
So it’s with interest I note the Moffit Cancer Center in Tampa Florida espouses a teamwork concept in cancer treatment with new targeted molecular therapies.
The IMO program’s approach is to develop mathematical models and computer simulations to link data that is obtained in a laboratory and the clinic. The models can provide insight into which drugs will or will not work in a clinical setting, and how to design more effective drug administration schedules, especially for drug combinations. The investigators collaborate with experts in the fields of biology, mathematics, computer science, imaging, and clinical science.
“Limited penetration may be one of the main causes that drugs that showed good therapeutic effect in laboratory experiments fail in clinical trials,” explained Rejniak. “Mathematical modeling can help us understand which tumor, or drug-related factors, hinder the drug penetration process, and how to overcome these obstacles.”
A similar story cropped up in in the Boston Globe – Harvard researchers use math to find smarter ways to defeat cancer
Now, a new study authored by an unusual combination of Harvard mathematicians and oncologists from leading cancer centers uses modeling to predict how tumors mutate to foil the onslaught of targeted drugs. The study suggests that administering targeted medications one at a time may actually insure that the disease will not be cured. Instead, the study suggests that drugs should be given in combination.
header picture: http://www.en.utexas.edu/Classes/Bremen/e316k/316kprivate/scans/hysteria.html