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Natural language processing to automate a web-based model of care and modernize skin cancer multidisciplinary team meetings.

Authors :
Ali, Stephen R
Dobbs, Thomas D
Tarafdar, Adib
Strafford, Huw
Fonferko-Shadrach, Beata
Lacey, Arron S
Pickrell, William Owen
Hutchings, Hayley A
Whitaker, Iain S
Source :
British Journal of Surgery. Jan2024, Vol. 111 Issue 1, p1-8. 8p.
Publication Year :
2024

Abstract

Background: Cancer multidisciplinary team (MDT) meetings are under intense pressure to reform given the rapidly rising incidence of cancer and national mandates for protocolized streaming of cases. The aim of this study was to validate a natural language processing (NLP)-based web platform to automate evidence-based MDT decisions for skin cancer with basal cell carcinoma as a use case. Methods: A novel and validated NLP information extraction model was used to extract perioperative tumour and surgical factors from histopathology reports. A web application with a bespoke application programming interface used data from this model to provide an automated clinical decision support system, mapped to national guidelines and generating a patient letter to communicate ongoing management. Performance was assessed against retrospectively derived recommendations by two independent and blinded expert clinicians. Results: There were 893 patients (1045 lesions) used to internally validate the model. High accuracy was observed when compared against human predictions, with an overall value of 0.92. Across all classifiers the virtual skin MDT was highly specific (0.96), while sensitivity was lower (0.72). Conclusion: This study demonstrates the feasibility of a fully automated, virtual, web-based service model to host the skin MDT with good system performance. This platform could be used to support clinical decision-making during MDTs as 'human in the loop' approach to aid protocolized streaming. Future prospective studies are needed to validate the model in tumour types where guidelines are more complex. What's already known about this topic? Cancer multidisciplinary team (MDT) meetings are under intense pressure to reform given the rapidly rising incidence of skin cancer and the national mandate for protocolized streaming. There is not enough time to discuss complex patients, attendance is not optimal, the right information is often not used to inform discussions and MDTs are unable to fulfil their secondary roles in data validation, audit and education. What does this study add? It is feasible that this platform could be used to support clinical decision making during the skin MDT as 'human in the loop' approach to aid protocolized streaming. This could aid management decisions for 'simple' cases and free up time to discuss more 'complex' patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00071323
Volume :
111
Issue :
1
Database :
Academic Search Index
Journal :
British Journal of Surgery
Publication Type :
Academic Journal
Accession number :
175496267
Full Text :
https://doi.org/10.1093/bjs/znad347