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 system Fletcher, Hall and Goldgof, 1999 Minimizing pain and cost Kokku, 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: 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-1 T-2 T-3

Example Test: Questions Numeric Question: White cell blood count MinMaxPrec

Eligibility Criteria A logical expression that determines eligibility for a specific treatment

Example: Criteria AND 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 / NoMultiple ChoiceNumeric

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 < to to 60 > 60

Input: Numeric Question Numeric Patient’s age Text Type MinMaxPrec

YesNo Input: Eligibility Logical structure AND OR Questions Sex Female Male Age Tumors? Lesions? YesNo Eligibility answers 4065 FromTo

Outline of the Talk Eligibility decisions Knowledge base Input of the knowledge Demonstration

Current System Online Demo

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