Can physician gestalt predict survival in patients with resectable pancreatic adenocarcinoma? Journal Article
| Authors: | Pak, L. M.; Gonen, M.; Seier, K.; Balachandran, V. P.; D’Angelica, M. I.; Jarnagin, W. R.; Kingham, T. P.; Allen, P. J.; Do, R. K. G.; Simpson, A. L. |
| Article Title: | Can physician gestalt predict survival in patients with resectable pancreatic adenocarcinoma? |
| Abstract: | Purpose: Clinician gestalt may hold unexplored information that can be capitalized upon to improve existing nomograms. The study objective was to evaluate physician ability to predict 2-year overall survival (OS) in resected pancreatic ductal adenocarcinoma (PDAC) patients based on pre-operative clinical characteristics and routine CT imaging. Methods: Ten surgeons and two radiologists were provided with a clinical vignette (including age, gender, presenting symptoms, and pre-operative CA19-9 when available) and pre-operative CT scan for 20 resected PDAC patients and asked to predict the probability of each patient reaching 2-year OS. Receiver operating characteristic curves were used to assess agreement and to compare performance with an established institutional nomogram. Results: Ten surgeons and 2 radiologists participated in this study. The area under the curve (AUC) for all physicians was 0.707 (95% CI 0.642–0.772). Attending physicians with > 5 years experience performed better than physicians with < 5 years of clinical experience since completion of post-graduate training (AUC = 0.710, 95% CI [0.536–0.884] compared to AUC = 0.662, 95% CI [0.398–0.927]). Radiologists performed better than surgeons (AUC = 0.875, 95% CI [0.765–0.985] compared to AUC = 0.656, 95% CI [0.580–0.732]). All but one physician outperformed the clinical nomogram (AUC = 0.604). Conclusions: This pilot study demonstrated significant promise in the quantification of physician gestalt. While PDAC remains a difficult disease to prognosticate, physicians, particularly those with more clinical experience and radiologic expertise, are able to perform with higher accuracy than existing nomograms in predicting 2-year survival. © 2017, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | survival; prediction; pancreatic adenocarcinoma; nomogram |
| Journal Title: | Abdominal Radiology |
| Volume: | 43 |
| Issue: | 8 |
| ISSN: | 2366-004X |
| Publisher: | Springer |
| Date Published: | 2018-08-01 |
| Start Page: | 2113 |
| End Page: | 2118 |
| Language: | English |
| DOI: | 10.1007/s00261-017-1407-x |
| PROVIDER: | scopus |
| PMCID: | PMC5967975 |
| PUBMED: | 29177926 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 September 2018 -- Source: Scopus |
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1030Gonen -
501Allen -
905Jarnagin -
257Do -
779D'Angelica -
612Kingham -
253Balachandran -
64Simpson -
30Pak -
107Seier
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