Summary
Background
A critical consideration when applying the results of a clinical trial to a particular
patient is the degree of similarity of the patient to the trial population. However,
similarity assessment rarely is practical in the clinical setting. Here, we explore
means to support similarity assessment by clinicians.
Methods
A scale chart was developed to represent the distribution of reported clinical and
demographic characteristics of clinical trial participant populations. Constructed
for an individual patient, the scale chart shows the patient’s similarity to the study
populations in a graphical manner. A pilot test case was conducted using case vignettes
assessed by clinicians. Two pairs of clinical trials were used, each addressing a
similar clinical question. Scale charts were manually constructed for each simulated
patient. Clinicians were asked to estimate the degree of similarity of each patient
to the populations of a pair of trials. Assessors relied on either the scale chart,
a summary table (aligning characteristics of 2 trial populations), or original trial
reports. Assessment time and between-assessor agreement were compared. Population
characteristics considered important by assessors were recorded.
Results
Six assessors evaluated 6 cases each. Using a visual scale chart, agreement between
physicians was higher and the time required for similarity assessment was comparable
Conclusion
We suggest that further research is warranted to explore visual tools facilitating
the choice of the most applicable clinical trial to a specific patient. Automating
patient and trial population characteristics extraction is key to support this effort.
Keywords
Data representation - clinical decision support systems - patient similarity - visual
scale
