Signal To Decision — Ali Torabi

Precision oncology has never lacked data What it lacks too often is a disciplined way to turn that data into a decision a clinician can defend a patient can understand and a board can stand behind A sequencing report a tracer avid lesion a drug label a polygenic score each is real and each is dangerous when read alone The variant without a pathology anchor the avid lesion without dosimetry the label without line of therapy context these are not rare mistakes They are the predictable result of starting from the test instead of from the question This book was written to invert that order Its organizing claim is simple and I hope durable a precision decision begins with a clinical question not a result and no recommendation is safe until pathology molecular findings imaging nuclear medicine germline status pharmacogenomics feasibility and the patient s own goals have been integrated and weighed Everything here the layer by layer reasoning the evidence tiers the one page board report the standing safety rules serves that single architecture active question data quality pathology anchor molecular interpretation lesion level imaging evidence tier feasibility recommendation owner follow up metric

Precision oncology has never lacked data What it lacks too often is a disciplined way to turn that data into a decision a clinician can defend a patient can understand and a board can stand behind A sequencing report a tracer avid lesion a drug label a polygenic score each is real and each is dangerous when read alone The variant without a pathology anchor the avid lesion without dosimetry the label without line of therapy context these are not rare mistakes They are the predictable result of starting from the test instead of from the question This book was written to invert that order Its organizing claim is simple and I hope durable a precision decision begins with a clinical question not a result and no recommendation is safe until pathology molecular findings imaging nuclear medicine germline status pharmacogenomics feasibility and the patient s own goals have been integrated and weighed Everything here the layer by layer reasoning the evidence tiers the one page board report the standing safety rules serves that single architecture active question data quality pathology anchor molecular interpretation lesion level imaging evidence tier feasibility recommendation owner follow up metric

Precision oncology has never lacked data What it lacks too often is a disciplined way to turn that data into a decision a clinician can defend a patient can understand and a board can stand behind A sequencing report a tracer avid lesion a drug label a polygenic score each is real and each is dangerous when read alone The variant without a pathology anchor the avid lesion without dosimetry the label without line of therapy context these are not rare mistakes They are the predictable result of starting from the test instead of from the question This book was written to invert that order Its organizing claim is simple and I hope durable a precision decision begins with a clinical question not a result and no recommendation is safe until pathology molecular findings imaging nuclear medicine germline status pharmacogenomics feasibility and the patient s own goals have been integrated and weighed Everything here the layer by layer reasoning the evidence tiers the one page board report the standing safety rules serves that single architecture active question data quality pathology anchor molecular interpretation lesion level imaging evidence tier feasibility recommendation owner follow up metric

Precision oncology has never lacked data What it lacks too often is a disciplined way to turn that data into a decision a clinician can defend a patient can understand and a board can stand behind A sequencing report a tracer avid lesion a drug label a polygenic score each is real and each is dangerous when read alone The variant without a pathology anchor the avid lesion without dosimetry the label without line of therapy context these are not rare mistakes They are the predictable result of starting from the test instead of from the question This book was written to invert that order Its organizing claim is simple and I hope durable a precision decision begins with a clinical question not a result and no recommendation is safe until pathology molecular findings imaging nuclear medicine germline status pharmacogenomics feasibility and the patient s own goals have been integrated and weighed Everything here the layer by layer reasoning the evidence tiers the one page board report the standing safety rules serves that single architecture active question data quality pathology anchor molecular interpretation lesion level imaging evidence tier feasibility recommendation owner follow up metric