Decision making tools for health care professionals
Intended Use of Adjuvant! Online
The recommended method for using Adjuvant! (this website and included software) is to have an experienced health professional enter the data on the website and then print out the results and the toxicity review sheets for the adjuvant regimens to be discussed.
These sheets are to be used to supplement, not substitute for, clinical judgment.
There are a number of areas where experienced clinicians disagree. In these instances Adjuvant! may present an evidence based interpretation and opinion, but this is not necessarily the only point of view. The structure of the program allows a health professional to modify its output in ways that they feel appropriate.
The use of the program should be as a shared utility between a health professional and a patient.
It is not for use by patients in the absence of health professional input.
The reasons for this are: First, the interpretation of some of the prognostic and staging information for any given person's case can be difficult even for an experienced professional. One reason is that surgical and pathologic reports are difficult to interpret. If information from these sources is misinterpreted very erroneous conclusions may result. Second, there is a concern that someone reviewing their prognosis alone (viewing them on this website) may find the information emotionally overwhelming. Although this may be unlikely since usually uninformed cancer survivors over estimate their risk of negative outcome (and Adjuvant! makes many people feel relieved and empowered), it seems reasonable to guard against the rare instances where great emotional stress happens in an unsupportive situation. By including at least both a health professional and the patient, social support and sense of moving toward a positive course of action is more assured. If you are a patient and want to see these estimates for yourself, it is suggested that you have your health care professional register to use this website so that they may generate and go over the results with you.
The best way to review of the results is by generating the printouts, rather than capturing results directly from the computer screen.