The University of Virginia Cancer Center is looking for a commercial partner to help it develop an electronic tool that will enable patients with prostate cancer to weigh the risks and potential benefits of treatment options.

“We basically have an analytic model, and we have a mock-up of what the app should look like,” said Timothy Showalter, MD, associate professor and residency program director of the Department of Radiation Oncology.

What UVA doesn’t have is the technological know-how to make it a reality. “We initially started to try and develop it on our own, but at the university level getting things into a useful format is generally easier if you have a team that has experience in developing commercial products—which we don’t have,” he says.

Despite the emergence of genomics-based risk prediction tools in oncology, Showalter and his colleagues say there is not yet an established framework for communication of test results to cancer patients to support shared decision-making.

The tool is envisioned as personalized decision aid for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy, providing options based on factors such as age, genetic testing and other health conditions. “We think it’s most useful in situations where a genomic test” is available to estimate the individual’s risk of cancer recurrence and for patients making decisions based on genetic testing results.

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One of the key metrics is a simplified graphical representation of quality-adjusted life years—a measure of the value of health outcomes, he notes.

“The idea for this is that patients could play with the model themselves and adjust it a little bit and see the changes [in terms of potential outcomes and side effects],” Showalter added. “It would be for discussion with their doctor. It’s not a tool from which to make a clinical decision, but it could help facilitate the decision and add some clarity.”

According to Showalter, UVA solicited feedback from 22 stakeholders to determine some key design elements for the tool, including the following requirements:

  • A web portal should be available for patients and providers to access the decision aid report at any time or place.
  • The decision aid needs to be accessible on computers and mobile devices and easily printable.
  • The tool should focus on anonymous data structures that are not automatically linked to electronic medical records.
  • The model should be interactive, enabling patients and clinicians to iteratively adjust model assumptions and observe the impact on model reports.

“There should be a private web portal, there should be the ability to print and it should be available both at home, before the physician appointment, and in the doctor's office as well,” he concluded. “And it should be used as part of that conversation with the physician about making a decision about whether to use radiation and the effects that might have.”

“I hope someone who is interested in partnering will see this,” added Showalter.

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