Evaluation of the relevance and access of EHR-based variables to support personalized medicine in breast cancer

Abstract

Background: The increasing number of available cancer therapies render medical decision-making (MDM) less straightforward. Patients want to know about the outcomes of similarly treated patients. Objective: The goal of this study was to design a breast cancer dashboard (BCD) tool that presents survival information to support MDM activities. Methods: Clinical variables during the clinic visit were determined via provider meetings and evaluated for accessibility from medical databases. Women with breast cancer (BC) were interviewed about their health care experiences after cancer diagnosis. We created a cohort of BC adult women treated at our institution from 1995 to 2012, from which clinical scenarios were defined and used to test survival outcomes. For the BCD, a simple, graphical user interface was built to present point-of-care clinical and survival data. Results: It is feasible to build the BCD using our institution’s databases and generate survival plots to facilitate MDM activities. Patients with early-stage BC had the highest survival rate (82.3%) and the longest mean life years of 7.0 (SD 4.5) years. In late-stage BC, poor prognosis outweighs the influence of number of comorbidities on mortality. The BCD tool promotes more predictive, personalized, and collaborative health care.

Keywords

• health care communication
• breast cancer
• personalized medicine
• medical decision making