Researchers from the University of British Columbia and BC Cancer have created an AI model that predicts cancer patient survival with greater accuracy and using more readily accessible data compared to previous methods.
The AI model utilizes natural language processing (NLP), a field of AI that comprehends human language, to examine oncologists’ notes taken following a patient’s initial consultation. This is the first step in a cancer patient’s journey after diagnosis. The model was able to identify distinctive features for each patient, resulting in survival predictions with over 80% accuracy for 6 months, 36 months, and 60 months. These findings were recently published in the JAMA Network Open.
“Predicting cancer survival is an important factor that can be used to improve cancer care,” said lead author Dr. John-Jose Nunez, a psychiatrist and clinical research fellow with the UBC Mood Disorders Centre and BC Cancer. “It might suggest health providers make an earlier referral to support services or offer a more aggressive treatment option upfront. Our hope is that a tool like this could be used to personalize and optimize the care a patient receives right away, giving them the best outcome possible.”
Traditionally, cancer survival rates have been calculated retrospectively and categorized by only a few generic factors such as cancer site and tissue type. Despite familiarity with these rates, it can be challenging for oncologists to accurately predict an individual patient’s survival due to the many complex factors that influence patient outcomes.
The model developed by Dr. Nunez and his collaborators, which includes researchers from BC Cancer and UBC’s departments of computer science and psychiatry, is able to pick up on unique clues within a patient’s initial consultation document to provide a more nuanced assessment. It is also applicable to all cancers, whereas previous models have been limited to certain cancer types.
“The AI essentially reads the consultation document similar to how a human would read it,” said Dr. Nunez. “These documents have many details like the age of the patient, the type of cancer, underlying health conditions, past substance use, and family histories. The AI brings all of this together to paint a more complete picture of patient outcomes.”
The researchers trained and tested the model using data from 47,625 patients across all six BC Cancer sites located across British Columbia. To protect privacy, all patient data remained stored securely at BC Cancer and was presented anonymously. Unlike chart reviews by human research assistants, the new AI approach has the added benefit of maintaining complete confidentiality of patient records.
“Because the model is trained on B.C. data, that makes it a potentially powerful tool for predicting cancer survival here in the province,” said Dr. Nunez.
In the future, the technology could be applied in cancer clinics across Canada and around the world.
“The great thing about neural NLP models is that they are highly scalable, portable, and don’t require structured data sets,” said Dr. Nunez. “We can quickly train these models using local data to improve performance in a new region. I would suspect that these models provide a good foundation anywhere in the world where patients are able to see an oncologist.”
Dr. Nunez is a recipient of the 2022/23 UBC Institute of Mental Health Marshall Fellowship, and is also supported by funding from the BC Cancer Foundation. In another stream of work, Dr. Nunez is examining how to facilitate the best-possible psychiatric and counseling care for cancer patients using advanced AI techniques. He envisions a future where AI is integrated into many aspects of the health system to improve patient care.
“I see AI acting almost like a virtual assistant for physicians,” said Dr. Nunez. “As medicine gets more and more advanced, having AI to help sort through and make sense of all the data will help inform physician decisions. Ultimately, this will help improve quality of life and outcomes for patients.”
Reference: “Predicting the Survival of Patients With Cancer From Their Initial Oncology Consultation Document Using Natural Language Processing” by John-Jose Nunez, MD, MSc, Bonnie Leung, MN-NP(F), Cheryl Ho, MD, Alan T. Bates, MD, Ph.D. and Raymond T. Ng, Ph.D., 27 February 2023, JAMA Network Open.
The study was funded by the BC Cancer Foundation.