Seminars in Oncology
Volume 37, Issue 1 , Pages 47-52, February 2010

Tailored Cancer Outcome Prediction and Informed Consent

  • Robert Patrick

      Affiliations

    • Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH
    • Corresponding Author InformationAddress correspondence to Robert Patrick, MD, MBA, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195
  • ,
  • Laura Buccini

      Affiliations

    • Department of Bioethics, Cleveland Clinic Foundation, Cleveland, OH
  • ,
  • Michael W. Kattan

      Affiliations

    • Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH

Clinically relevant disparities in the outcomes of cancer treatment between institutions are well established. Some authors have argued that physicians have an ethical obligation to disclose these disparities as part of the informed consent process.1 We believe that preservation of patient autonomy requires disclosure of treatment institution-specific outcomes and that statistical prediction models tailored to individual patients are the best way to frame this discussion. We describe a utopian system to gather and disseminate cancer outcome data based on the United Network for Organ Sharing and articulate why accurate and equitable prediction models are feasible both scientifically and logistically. We also discuss strategies of design and oversight required to mitigate any unintended negative downstream consequences of such a system.

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PII: S0093-7754(09)00233-4

doi:10.1053/j.seminoncol.2009.12.008

Seminars in Oncology
Volume 37, Issue 1 , Pages 47-52, February 2010