In our lab we’re setting up the PCA3-test designed to aid prostate cancer diagnostics. The test is representative of many emerging diagnostic tests in that it is a) a supplement to existing testing and b) useful only in a subset of conditions.
The PCA3-test complements results from digital rectal examination, PSA tests, and prostate biopsies. Three tests that until recently have constituted the cornerstones of prostate cancer screening and diagnostics. The relationship between the results from these tests is dynamic and interpretation of test results is often complicated, sometimes very confusing and can, in the worst case, be very uncertain. Add the gene expression results from the PCA3-test and you have a lot of valuable information, but a tough time filtering it into useful clinical information.
Physicians will learn how to combine the information either in med-school or in update learning courses later in their career. A slow and sometimes insufficient way to convey diagnostic information to the clinic, treating physician and ultimately, the patient.
Thankfully, we live in the information age and medicine 2.0 is well underway. Now the doctor or the patient can separately or together get online assistance in interpreting prostate cancer test-results. Well designed and user-friendly calculators like the “Risk of Biopsy Detectable Prostate Cancer” calculator or prostatecancer-riskcalculator.com (professional use) will help anyone undertand and begin to interpret lab-results. A big step forward in my opinion since information flow becomes quick and targeted.
Such calculators have also been made available for cancer risk prediction: nomograms.org, for Marevan/Warfarin dosing: Warfarindosing.org, and as demonstrated in a previous post, for Testosterone: Testosterone.
There are probably a lot of calculators out there that I haven’t found yet and it’s highly likely that many more will be developed.
It seems clear to me that interpretation of clinical lab-results may not remain entirely in the physician domain much longer. Hopefully such automated interpretation will lead to patient empowerment and make deciding on clinical action an easier task.