title: Structured decision-making: using personalized medicine to improve the value of cancer care.
abstract: Cancer care is often inconsistently delivered with inadequate incorporation of patient values and objective evidence into decision-making. Utilization of time limited trials of care with predefined decision points that are based on iteratively updated best evidence, tools that inform providers about a patient's experience and values, and known information about a patient's disease will allow superior matched care to be delivered. Personalized medicine does not merely refer to the incorporation of genetic information into clinical care, it involves utilization of the wide array of data points relevant to care, many of which are readily available at the bedside today. By pushing uptake of personalized matching available today, clinicians can better address the triple aim of improved health, lowers costs, and enhanced patient experience, and we can prepare the health care landscape for the iterative inclusion of progressively more sophisticated information as newer tests and information become available to support the personalized medicine paradigm.
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. Bradford.hirsch@duke.edu.
authors.forename: Bradford R
authors.initials: BR
authors.lastname: Hirsch
authors.affiliation: Center for Learning Health Care, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. amy.abernethy@duke.edu.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy