"A Tool, Not a Crutch": Patient Perspectives About IBM Watson for Oncology Trained by Memorial Sloan Kettering

Abstract

Purpose: IBM Watson for Oncology trained by Memorial Sloan Kettering (WFO) is a clinical decision support tool designed to assist physicians in choosing therapies for patients with cancer. Although substantial technical and clinical expertise has guided the development of WFO, patients' perspectives of this technology have not been examined. To facilitate the optimal delivery and implementation of this tool, we solicited patients' perceptions and preferences about WFO.

Methods: We conducted nine focus groups with 46 patients with breast, lung, or colorectal cancer with various treatment experiences: neoadjuvant/adjuvant chemotherapy, chemotherapy for metastatic disease, or systemic therapy through a clinical trial. In-depth qualitative and quantitative data were collected and analyzed to describe patients' attitudes and perspectives concerning WFO and how it may be used in clinical care.

Results: Analysis of the qualitative data identified three main themes: patient acceptance of WFO, physician competence and the physician-patient relationship, and practical and logistic aspects of WFO. Overall, participant feedback suggested high levels of patient interest, perceived value, and acceptance of WFO, as long as it was used as a supplementary tool to inform their physicians' decision making. Participants also described important concerns, including the need for strict processes to guarantee the integrity and completeness of the data presented and the possibility of physician overreliance on WFO.

Conclusion: Participants generally reacted favorably to the prospect of WFO being integrated into the cancer treatment decision-making process, but with caveats regarding the comprehensiveness and accuracy of the data powering the system and the potential for giving WFO excessive emphasis in the decision-making process. Addressing patients' perspectives will be critical to ensuring the smooth integration of WFO into cancer care.

Fig 1.

Participant responses to the study questionnaire regarding perceptions of a physician who used IBM Watson for Oncology trained by Memorial Sloan Kettering (WFO). Participants responded to each item after being instructed to “Imagine a doctor used IBM Watson for Oncology to decide which chemotherapy to use to treat your cancer.” The first two items reflect the main theme of patient acceptance of WFO. All remaining items reflect the main theme of physician competence and the physician-patient relationship.

Fig A1.

Participant responses to the study questionnaire regarding IBM Watson for Oncology trained by Memorial Sloan Kettering. Participants responded to the item: “What would you want IBM Watson for Oncology to consider when it makes a recommendation about your chemotherapy?” Participants could select multiple responses. Participants who selected “other” clarified their responses as: “survival rates from different chemo treatments,” “benefit vs other treatments (endocrine vs radiation vs chemo),” “all scientific resources,” “experience and side effects from previous chemotherapy with overlapping drugs,” “% potential of outcome,” and “other options.”