title: Model-assisted predictions on prognosis in HNSCC: do we learn?
abstract: Dedicated software packages incorporating prognostic models are meant to aid physicians in making accurate predictions of prognosis. This study concerns 742 predictions of 5-year survival on consecutive newly diagnosed patients with head- and neck squamous cell carcinoma. The 5-year survival predictions made by the physicians are not compared with actual survival, but with a prediction made by OncologIQ, a dedicated software package. We used a linear regression and a linear mixed-effects model to look at absolute differences between both predictions and possible learning effects. Predictions made by the physicians were optimistic and inaccurate. Using the linear regression and linear mixed-effects models, the physicians' learning effect showed little improvement per successive prediction. We conclude that prognostic predictions in general are imprecise. When given feedback on the model's predicted survival, the accuracy increases, but only very modestly.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus Medical Center, P.O. Box 1738, 3015 CE, Rotterdam, The Netherlands. m.vanderschroeff@erasmusmc.nl
authors.forename: Marc P
authors.initials: MP
authors.lastname: van der Schroeff
authors.forename: Kim
authors.initials: K
authors.lastname: van Schie
authors.forename: Ton P M
authors.initials: TP
authors.lastname: Langeveld
authors.forename: Caspar
authors.initials: C
authors.lastname: Looman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Baatenburg de Jong
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D003198:Computer Simulation; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D005246:Feedback; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D010353:Patient Education as Topic; D011379:Prognosis; D012984:Software
references.citation: Br J Cancer. 2006 Jan 30;94(2):208-12
references.pmid: 16404420
references.citation: J Clin Epidemiol. 1997 Jan;50(1):21-9
references.pmid: 9048687
references.citation: Cancer. 1999 Jul 1;86(1):170-6
references.pmid: 10391577
references.citation: Thorax. 1996 Sep;51(9):894-902
references.pmid: 8984699
references.citation: BMJ. 2000 Feb 19;320(7233):469-72
references.pmid: 10678857
references.citation: Head Neck. 2001 Sep;23(9):718-24
references.pmid: 11505480
references.citation: Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):870-3
references.pmid: 15708268
references.citation: Biometrics. 1982 Dec;38(4):963-74
references.pmid: 7168798
references.citation: Br Med J. 1972 Apr 1;2(5804):29-31
references.pmid: 4111472