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Academia and the Profession |

The Treatment Advice of a Computer-Based Cancer Chemotherapy Protocol Advisor

DAVID H. HICKAM, M.D., M.P.H.; EDWARD H. SHORTLIFFE, M.D., Ph.D.; MIRIAM B. BISCHOFF, M.S.; A. CARLISLE SCOTT, M.S.; and CHARLOTTE D. JACOBS, M.D.
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Grant support: in part by grants LM-03395, LM-00048, RR-00785, and RR-01631 from the National Institutes of Health. Dr. Hickam was a Henry J. Kaiser Family Foundation General Internal Medicine Fellow. Dr. Shortliffe is a Henry J, Kaiser Family Foundation Faculty Scholar in General Internal Medicine. Dr. Jacobs is an American Cancer Society Junior Faculty Scholar.

Presented in part at the Fifth Annual Meeting of the Society for Medical Decision Making, October 1983.

▸Requests for reprints should be addressed to Edward H. Shortliffe, M.D., Ph.D.; Medical Computer Science, TC-135, Stanford University Medical Center; Stanford, CA 94305.


Stanford, California


©1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;103(6_Part_1):928-936. doi:10.7326/0003-4819-103-6-928
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Oncocin is a chemotherapy protocol advisor used experimentally in a university oncology clinic. The program combines formal protocol guidelines with judgments of oncologists who have experience adjusting therapy in complex clinical situations. We compared the chemotherapy administered by clinic physicians with the treatment that would have been recommended by ONCOCIN in 415 visits for 39 patients with lymphoma seen before the program's introduction. In 189 visits the program agreed with the therapy actually administered. In a blinded evaluation, four experts on lymphoma failed to find a significant difference between the treatments selected by physicians and those proposed by ONCOCIN. Further analyses showed that ONCOCIN tended to attenuate drug doses or delay treatment more than the experts recommended, whereas the physicians were less likely to attenuate doses to the extent the experts suggested. Our results show that ONCOCIN provides advice on lymphoma treatment similar to the treatment provided in a university oncology clinic.

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