title: Great expectations: use of molecular tests and computerised prognostic tools in New Zealand cancer care.
abstract: BACKGROUND
  Use of molecular tests and computerised prognostic tools designed to individualise cancer care appears to be rapidly increasing in New Zealand. These tests have important clinical and health economic implications, but their impact on cancer care has not been fully assessed.
  
  
  OBJECTIVE
  To determine cancer clinicians' use of and expectations for molecular tests and computerised prognostic tools.
  
  
  METHODS
  Online survey of clinicians managing cancer in New Zealand.
  
  
  RESULTS
  137 clinicians participated, 31% used molecular tests and 57% used computerised prognostic tools. These technologies affected clinical decisions made by a quarter of participants. Over 85% of participants believed that the impact of molecular tests and computerised prognostic tools would increase over the next decade and that a stronger evidence base would support their use.
  
  
  CONCLUSIONS
  Molecular tests and computerised prognostic tools already influence treatment provided to many New Zealand cancer patients. Clinicians who participated in this survey overwhelmingly expect the use of these tests to increase, which has important clinical implications since there is little high quality prospective data assessing the ability of these tests to improve patient outcomes. Expanded use of these often-expensive tests also has economic implications. The role of these technologies needs to be considered in the context of a wide-ranging cancer control strategy.
authors.affiliation: Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand. deborah.wright@auckland.ac.nz
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Wright
authors.forename: Rob
authors.initials: R
authors.lastname: McNeill
authors.forename: Arend E H
authors.initials: AE
authors.lastname: Merrie
authors.forename: Cristin G
authors.initials: CG
authors.lastname: Print
mesh_terms: D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000628:therapy*; D003110:Colonic Neoplasms / Q000628:therapy*; D003362:Cost-Benefit Analysis; D004252:DNA Mutational Analysis; D003658:Decision Making, Computer-Assisted; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data; D006405:Hematology / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D008495:Medical Oncology / Q000706:statistics & numerical data; D009520:New Zealand; D009862:Online Systems; D010336:Pathology / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011379:Prognosis; D018787:Radiation Oncology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D014408:Biomarkers, Tumor