title: A comparison between clinical decisions made about lung cancer patients and those inherent in the corresponding Scottish Intercollegiate Guidelines Network (SIGN) guideline.
abstract: Treatment and survival for patients with lung cancer vary between and within countries. We have undertaken a multifaceted study of a clinical dataset of 635 patients, to see if clinician treatment decisions were being made consistently and in accordance with the appropriate Scottish Intercollegiate Guidelines Network (SIGN) document. Subsequently, we created a dataset of 117 patients who should have undergone surgery according to the SIGN guideline. As analyses of this dataset did not provide clear distinctions between the main treatment groups, a clinician reviewed the case notes and dataset, checking for inconsistencies. The revised dataset was processed by a decision tree algorithm which suggests clinically plausible decisions. Further, statistical analyses compared the 54 patients offered surgery with the 52 who were not. These analyses suggest that there are significant differences: the most discriminating feature is significant co-morbidity (p < 0.001). The article concludes with suggestions for how future guidelines might be enhanced.
authors.affiliation: Department of Computing Science, University of Aberdeen, UK. d.sleeman@abdn.ac.uk
authors.forename: Derek
authors.initials: D
authors.lastname: Sleeman
authors.forename: Laura
authors.initials: L
authors.lastname: Moss
authors.forename: Elias
authors.initials: E
authors.lastname: Gyftodimos
authors.forename: Marianne
authors.initials: M
authors.lastname: Nicolson
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
mesh_terms: D000465:Algorithms; D003657:Decision Making; D003663:Decision Trees; D019983:Guideline Adherence; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012606:Scotland