Making Patient-Specific Treatment Decisions Using Prognostic Variables and Utilities of Clinical Outcomes

Cancers

Peter F. Thall¹  Pavlos Msaouel²  Juhee Lee³ 

[1] Department of Biostatistics, Division of Basic Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 70030, USA;Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;Department of Statistics, University of California Santa Cruz, Santa Cruz, CA 95064, USA;

关键词: individualized inferences;    patient-specific decision-making;    precision medicine;    prognostic biomarkers;    utilities;   

DOI  :  10.3390/cancers13112741

来源: DOAJ

【 摘 要 】

We argue that well-informed patient-specific decision-making may be carried out as three consecutive tasks: (1) estimating key parameters of a statistical model, (2) using prognostic information to convert these parameters into clinically interpretable values, and (3) specifying joint utility functions to quantify risk–benefit trade-offs between clinical outcomes. Using the management of metastatic clear cell renal cell carcinoma as our motivating example, we explain the role of prognostic covariates that characterize between-patient heterogeneity in clinical outcomes. We show that explicitly specifying the joint utility of clinical outcomes provides a coherent basis for patient-specific decision-making.

【 授权许可】

Unknown