{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:19:34Z","timestamp":1790461174608,"version":"4.1.0"},"reference-count":49,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2012,12,27]],"date-time":"2012-12-27T00:00:00Z","timestamp":1356566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Cancer care is often inconsistently delivered with inadequate incorporation of patient values and objective evidence into decision-making. Utilization of time limited trials of care with predefined decision points that are based on iteratively updated best evidence, tools that inform providers about a patient\u2019s experience and values, and known information about a patient\u2019s disease will allow superior matched care to be delivered. Personalized medicine does not merely refer to the incorporation of genetic information into clinical care, it involves utilization of the wide array of data points relevant to care, many of which are readily available at the bedside today. By pushing uptake of personalized matching available today, clinicians can better address the triple aim of improved health, lowers costs, and enhanced patient experience, and we can prepare the health care landscape for the iterative inclusion of progressively more sophisticated information as newer tests and information become available to support the personalized medicine paradigm.<\/jats:p>","DOI":"10.3390\/jpm3010001","type":"journal-article","created":{"date-parts":[[2012,12,27]],"date-time":"2012-12-27T11:08:31Z","timestamp":1356606511000},"page":"1-13","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Structured Decision-Making: Using Personalized Medicine to Improve the Value of Cancer Care"],"prefix":"10.3390","volume":"3","author":[{"given":"Bradford","family":"Hirsch","sequence":"first","affiliation":[{"name":"Center for Learning Health Care, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA"},{"name":"Division of Medical Oncology, Department of Medicine, Duke University Medical Center Box 3436, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Abernethy","sequence":"additional","affiliation":[{"name":"Center for Learning Health Care, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA"},{"name":"Division of Medical Oncology, Department of Medicine, Duke University Medical Center Box 3436, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2012,12,27]]},"reference":[{"key":"ref_1","unstructured":"FDA Approved Drugs by Therapeutic Area. Available online:http:\/\/www.centerwatch.com\/drug-information\/fda-approvals\/drug-areas.aspx?AreaID=12."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1158\/1078-0432.CCR-11-2019","article-title":"Impact of genomics on personalized cancer medicine","volume":"18","author":"Arteaga","year":"2012","journal-title":"Clin. Cancer Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1038\/464674a","article-title":"Has the revolution arrived?","volume":"464","author":"Collins","year":"2010","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e40294","DOI":"10.1371\/journal.pone.0040294","article-title":"Limitations of the human reference genome for personalized genomics","volume":"7","author":"Rosenfeld","year":"2012","journal-title":"PLoS One"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJMp1006114","article-title":"The \u201cmeaningful use\u201d regulation for electronic health records","volume":"363","author":"Blumenthal","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/jama.2012.500","article-title":"The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda","volume":"307","author":"Selby","year":"2012","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/ije\/dym276","article-title":"The UK Biobank sample handling and storage protocol for the collection, processing and archiving of human blood and urine","volume":"37","author":"Elliott","year":"2008","journal-title":"Int J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1056\/NEJMp1014427","article-title":"Developing the Sentinel System\u2014A national resource for evidence development","volume":"364","author":"Behrman","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-0038-1637943","article-title":"Managing clinical knowledge for health care improvement","volume":"9","author":"Balas","year":"2000","journal-title":"Yearb. Med. Inform."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1056\/NEJMp0901592","article-title":"Stimulating the adoption of health information technology","volume":"360","author":"Blumenthal","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_11","unstructured":"Institute of Medicine (2010). Value in Health Care: Accounting for Cost, Quality, Safety, Outcomes, and Innovation: Workshop Summary, The National Academies Press."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1586\/erm.12.46","article-title":"How many molecular subtypes? Implications of the unique tumor principle in personalized medicine","volume":"12","author":"Ogino","year":"2012","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1056\/NEJMoa1207756","article-title":"Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival","volume":"367","author":"Liao","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.6004\/jnccn.2011.0137","article-title":"NCCN Task Force report: Evaluating the clinical utility of tumor markers in oncology","volume":"9","author":"Febbo","year":"2011","journal-title":"J. Natl. Compr. Canc. Netw."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/S1470-2045(10)70209-6","article-title":"KRAS, BRAF, PIK3CA, and PTEN mutations: Implications for targeted therapies in metastatic colorectal cancer","volume":"12","author":"Normanno","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1093\/jnci\/djp386","article-title":"Adverse symptom event reporting by patients vs. clinicians: Relationships with clinical outcomes","volume":"101","author":"Basch","year":"2009","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.jpainsymman.2009.05.025","article-title":"Assessing the Symptoms of Cancer Using Patient-Reported Outcomes (ASCPRO): Searching for standards","volume":"39","author":"Cleeland","year":"2010","journal-title":"J. Pain Symptom Manage."},{"key":"ref_18","first-page":"530","article-title":"Agreement between patient-reported symptoms and their documentation in the medical record","volume":"14","author":"Pakhomov","year":"2008","journal-title":"Am. J. Manag. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1097\/MLR.0b013e3181db53a4","article-title":"Electronic patient-reported data capture as a foundation of rapid learning cancer care","volume":"48","author":"Abernethy","year":"2010","journal-title":"Med. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.jpainsymman.2008.07.011","article-title":"Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: Pilot study of an e\/Tablet data-collection system in academic oncology","volume":"37","author":"Abernethy","year":"2009","journal-title":"J. Pain Symptom Manage."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1111\/j.1475-6773.2008.00887.x","article-title":"Improving health care efficiency and quality using tablet personal computers to collect research-quality, patient-reported data","volume":"43","author":"Abernethy","year":"2008","journal-title":"Health Serv. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1200\/JOP.2011.000434","article-title":"Longitudinal patient-reported performance status assessment in the cancer clinic is feasible and prognostic","volume":"7","author":"Suh","year":"2011","journal-title":"J. Oncol. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jpainsymman.2010.01.017","article-title":"Validation of the Patient Care Monitor (Version 2.0): A review of system assessment instrument for cancer patients","volume":"40","author":"Abernethy","year":"2010","journal-title":"J. Pain Symptom Manage."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1007\/s00520-010-0823-z","article-title":"Phase 2 pilot study of Pathfinders: A psychosocial intervention for cancer patients","volume":"18","author":"Abernethy","year":"2010","journal-title":"Support. Care Cancer"},{"key":"ref_25","first-page":"91","article-title":"Use of tablet personal computers for sensitive patient-reported information","volume":"7","author":"Dupont","year":"2009","journal-title":"J. Support. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s00520-010-0819-8","article-title":"Coping with sexual concerns after cancer: The use of flexible coping","volume":"18","author":"Reese","year":"2010","journal-title":"Support. Care Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s00520-009-0738-8","article-title":"Sexual concerns in cancer patients: A comparison of GI and breast cancer patients","volume":"18","author":"Reese","year":"2010","journal-title":"Support. Care Cancer"},{"key":"ref_28","unstructured":"Gliklich, R.E., and Dreyer, N.A.E. (2010). Registries for Evaluating Patient Outcomes: A User\u2019s Guide, 2nd ed., (Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. d\/b\/a Outcome] under Contract No. HHSA29020050035I TO3.), Agency for Healthcare Research and Quality."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"341","DOI":"10.7326\/0003-4819-151-5-200909010-00139","article-title":"Design of a national distributed health data network","volume":"151","author":"Maro","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jbi.2010.11.008","article-title":"The DEDUCE Guided Query tool: Providing simplified access to clinical data for research and quality improvement","volume":"44","author":"Horvath","year":"2011","journal-title":"J. Biomed. Inform."},{"key":"ref_31","unstructured":"Kanter Health Learning Health System Summit. Available online:http:\/\/kanterhealth.org\/featured\/2012-summit\/."},{"key":"ref_32","unstructured":"Institute of Medicine Digital Learning Collaborative: Advancing the Digital Infrastructure for the Learning Health System. Available online:http:\/\/www.iom.edu\/Activities\/Quality\/VSRT\/~\/ media\/Files\/Activity Files\/Quality\/VSRT\/Core Documents\/Digital Learning Collaborative.pdf."},{"key":"ref_33","unstructured":"Institute of Medicine (2012). Achieving Data Liquidity in the Cancer Community: Proposal for a coAlition of Stakeholders, The National Academies Press."},{"key":"ref_34","unstructured":"Institute of Medicine (2012). Informatics Needs and Challenges in Cancer Research: Workshop Summary, The National Academies Press."},{"key":"ref_35","unstructured":"Institute of Medicine (2007). The Learning Healthcare System: Workshop Summary (IOM Roundtable on Evidence-Based Medicine), The National Academies Press."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jcrc.2006.06.002","article-title":"The checklist\u2014A tool for error management and performance improvement","volume":"21","author":"Hales","year":"2006","journal-title":"J. Crit. Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1056\/NEJMoa061115","article-title":"An intervention to decrease catheter-related bloodstream infections in the ICU","volume":"355","author":"Pronovost","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S292","DOI":"10.1097\/CCM.0b013e3181e6a165","article-title":"Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections","volume":"38","author":"Sawyer","year":"2010","journal-title":"Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1377\/hlthaff.2010.0666","article-title":"Why observational studies should be among the tools used in comparative effectiveness research","volume":"29","author":"Dreyer","year":"2010","journal-title":"Health Aff."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kawamoto, K., Houlihan, C.A., Balas, E.A., and Lobach, D.F. (2005). Improving clinical practice using clinical decision support systems: A systematic review of trials to identify features critical to success. BMJ.","DOI":"10.1136\/bmj.38398.500764.8F"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s11606-008-0504-5","article-title":"The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: A systematic review","volume":"23","author":"Wolfstadt","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1001\/jama.2011.1954","article-title":"Time-Limited Trials (letter to editor)","volume":"307","author":"Abernethy","year":"2012","journal-title":"JAMA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1001\/jama.2011.1413","article-title":"Time-limited trials near the end of life","volume":"306","author":"Quill","year":"2012","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1197\/jamia.M1700","article-title":"The impact of electronic health records on time efficiency of physicians and nurses: A systematic review","volume":"12","author":"Poissant","year":"2005","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_45","first-page":"206","article-title":"The PDSA cycle at the core of learning in health professions education","volume":"22","author":"Cleghorn","year":"1996","journal-title":"Jt. Comm. J. Qual. Improv."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Friedman, C.P., Wong, A.K., and Blumenthal, D. (2010). Achieving a nationwide learning health system. Sci. Transl. Med., 2.","DOI":"10.1126\/scitranslmed.3001456"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4243","DOI":"10.1200\/JCO.2012.42.8011","article-title":"Importance of Health Information Technology, Electronic Health Records, and Continuously Aggregating Data to Comparative Effectiveness Research and Learning Health Care","volume":"30","author":"Miriovsky","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4268","DOI":"10.1200\/JCO.2010.28.5478","article-title":"Rapid-learning system for cancer care","volume":"28","author":"Abernethy","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"207","DOI":"10.7326\/0003-4819-157-3-201208070-00012","article-title":"Implementing the learning health system: From concept to action","volume":"157","author":"Greene","year":"2012","journal-title":"Ann. Intern. Med."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/3\/1\/1\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:54:31Z","timestamp":1760219671000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/3\/1\/1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,27]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2013,3]]}},"alternative-id":["jpm3010001"],"URL":"https:\/\/doi.org\/10.3390\/jpm3010001","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12,27]]}}}