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A Proposed Application of Systems Engineering Principles to Healthcare Decision-Making: Evaluating Patient Decision Regret in the Treatment of Oropharyngeal Cancer

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Systems Engineering in Context

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Abstract

Healthcare decision-making for complex and chronic diseases, including cancer, is a systems engineering problem. Interventions used to treat these medical conditions frequently require the coordination of multiple specialty entities that define available action space. At the same time, considerations for the preferences of patients in a shared decision-making environment introduce alternatives that magnify computational complexity. In this research, we employ multidisciplinary design optimization (MDO) to address an emerging healthcare issue—human papillomavirus (HPV)-positive oropharyngeal cancer (OPC)—and evaluate the conformity of various interventions that may reduce treatment burden while pursuing patient longevity for this unique disease. An implementation of the proposed algorithm demonstrates behavior consistent with regret avoidance, while a more robust model will allow both patient-physician and healthcare system feedback in optimizing treatment policies.

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Abbreviations

CES:

Complex engineered systems

DA:

Decision aid

DR:

Decision regret

HNC:

Head and neck cancer

HPV:

Human papillomavirus

MDM:

Medical decision-making

MDO:

Multidisciplinary design optimization

OPC:

Oropharyngeal cancer

QoL:

Quality of life

SDM:

Shared decision-making

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Author information

Authors and Affiliations

  1. George Mason University, Fairfax, VA, USA

    Robert T. Aarhus Jr. & Edward Huang

Authors
  1. Robert T. Aarhus Jr.
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  2. Edward Huang
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Corresponding author

Correspondence to Robert T. Aarhus Jr. .

Editor information

Editors and Affiliations

  1. Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA

    Stephen Adams

  2. Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA

    Peter A. Beling

  3. Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA

    James H. Lambert

  4. Department of Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA

    William T. Scherer

  5. Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA

    Cody H. Fleming

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Aarhus, R.T., Huang, E. (2019). A Proposed Application of Systems Engineering Principles to Healthcare Decision-Making: Evaluating Patient Decision Regret in the Treatment of Oropharyngeal Cancer. In: Adams, S., Beling, P., Lambert, J., Scherer, W., Fleming, C. (eds) Systems Engineering in Context. Springer, Cham. https://doi.org/10.1007/978-3-030-00114-8_17

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