Assessing the Efficacy of a CDSS for Breast Cancer

摘要

The five-year project developed and tested a computer-based decision support system (CDSS) on breast cancer for low-income women who speak English or Spanish. The populations included in the study are predominantly African American and Hispanic women. Hispanic women included a high proportion who speak only Spanish and have only limited English proficiency. Delivery of the educational message involves use of computer-based instruction to provide for an interactive learning experience. A unique feature of the project is the use of decision analysis techniques to assess the effectiveness of the CDSS program in facilitating treatment choices that are most likely to lead to outcomes preferred by patients. The application of decision analysis methods involves generation of patient-specific utilities that can be plugged into the analytical model for the purpose of comparing descriptive choices--those actually made by women with early stage breast cancer--against prescriptive choices--those that are determined to result in preferred outcomes for an individual patient as determined from application of the modeling program. We have completed recruitment into the clinical and follow-up assessments are still ongoing. A preliminary evaluation of the project has been conducted.