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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
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