Coding of Selection Criteria for Cancer Treatment Plans Savvas Nikiforou
Dec 20, 2015
Coding of Selection Criteria for Cancer Treatment Plans
Savvas Nikiforou
Automated Matching of Patients to Clinical Trials
Part of the project:
Research Group
• Faculty– Lawrence Hall
– Dmitry Goldgof
– Eugene Fink
• Students– Lynn Fletcher
– Princeton Kokku
– Savvas Nikiforou
– Rochelle Harris
Motivation
• Selecting among treatment plans
• Minimizing pain and cost of the selection process
• Reducing the physician’s effort
Expert System
• Guides the nurse through related questions
• Identifies the appropriate medical tests
Outline of the Talk
• Eligibility decisions
• Knowledge base
• Input of the knowledge
• Demonstration
Related Work
• Initial expert systemFletcher, Hall and Goldgof, 1999
• Minimizing pain and costKokku, Hall and Goldgof, 2001
Example: Selection Criteria
• Female, not older than 50
• Breast cancer, stage II
• No prior surgery
Example: Questions
Sex:
Age:
Female
Male
35
Example: Conclusion
Patient is not eligible
Example: Questions
Sex:
Age:
Female
Male
35
Example: Questions
Cancer stage:
Prior surgery? Yes No Unknown
I
II
III
IV
Example: Conclusion
Patient is eligible
Full Functionality
• Orders and groups the questions
• Considers multiple treatment plans
Old System
• A programmer has to code the questions
New System
• A programmer has to code the questions
• A nurse enters the questions through a friendly interface
• Problem: Build the interface
Outline of the Talk
• Eligibility decisions
• Knowledge base
• Input of the knowledge
• Demonstration
Main Objects
• Questions
• Tests
• Eligibility criteria
Types of Questions
• Yes / No / Unknown
• Multiple choice
• Numeric
Examples of Questions
Prior surgery? Yes No Unknown
Examples of Questions
Prior surgery? Yes No Unknown
Cancer stage: I
II
III
IV
Examples of Questions
Prior surgery? Yes No Unknown
Cancer stage: I
II
III
IV
Age:
Tests
A medical test answers several questions.
It involves certain pain and cost.
Example Test: Name and Cost
Test Name:
Cost: 42.23
Pain: 1
Blood test
Example Test: Questions
• Yes / No
Question:
Histologically proven breast cancer?
Example Test: Questions
• Multiple choice
Question: Options:
Patient’s clinical state T-1T-2T-3
Example Test: Questions
• Numeric
Question: White cell blood count 0 500000 0
Min Max Prec
Eligibility Criteria
• A logical expression that determines eligibility for a specific treatment
Example: CriteriaAND
White Blood Count >100,000
No Heart Related Problems
OR
Cancer Stage I
Cancer Stage II
Outline of the Talk
• Eligibility decisions
• Knowledge base
• Input of the knowledge
• Demonstration
Input
• Questions
• Tests
• Eligibility criteria
Input: Test
• Name:
• Cost:
• Pain:
Type test name here
$$$$.$$
0-5
Input: Question Format
• Text
• Type
Yes / No Multiple Choice Numeric
Input: Yes / No Question
Yes / No
Is patient’s age less than 64?
• Text
• Type
Input: Multiple Choice Question
Multiple Choice
Patient’s age
• Text
• Type
Options
< 20
20 to 40
41 to 60
> 60
Input: Numeric Question
Numeric
Patient’s age
• Text
• Type
Min Max Prec.
1200 0
Yes No
Input: Eligibility
• Logical structure AND
OR
• Questions
SexFemaleMale
Age
Tumors?
Lesions?
Yes No• Eligibility answers
40 65From To
Outline of the Talk
• Eligibility decisions
• Knowledge base
• Input of the knowledge
• Demonstration
Main results
• Formal model of selection criteria and related optimization problems
• Friendly input interface
• Visual representation of these criteria
Coming soon
• Completion of the interface
• Converting the input knowledge into internal logical structures