Tool support to enable evaluation of the clinical response to treatment.

Objective criteria for measuring response to cancer treatment are critical to clinical research and practice. The National Cancer Institute has developed the Response Evaluation Criteria in Solid Tumors (RECIST) method to quantify treatment response. RECIST evaluates response by assessing a set of measurable target lesions in baseline and follow-up radiographic studies. However, applying RECIST consistently is challenging due to inter-observer variability among oncologists and radiologists in choice and measurement of target lesions. We analyzed the radiologist-oncologist workflow to determine whether the information collected is sufficient for reliably applying RECIST. We evaluated radiology reports and image markup (radiologists), and clinical flow sheets (oncologists). We found current reporting of radiology results insufficient for consistent application of RECIST, compared with flow sheets. We identified use cases and functional requirements for an informatics tool that could improve consistency and accuracy in applying methods such as RECIST.