No abstract

Does objective probability affect P300 size independently and in addition to subjective probability? The latter was manipulated by the number of stimuli presented and classification task. Five groups saw target and frequent stimuli. Two saw these with p=.2 or .067, with two different button presses. Three groups saw two additional nontarget stimuli each with p=.067. One group pressed a different button for each stimulus. A second group pressed one button for the three oddballs, another for the frequent. A third critical group pressed one button for the target and another for other stimuli. In this group, P300 was larger for targets versus nontargets, and larger for nontargets versus frequents. Although nontargets were classified with frequents, their actual low probability distinguished them from frequents, and their subjective probability distinguished them from targets. Therefore, actual and subjective probability effects were independently found.

Oncotype DX, a gene-expression profiling assay, provides stratification of patients with estrogen-receptor positive, lymph-node-negative early breast cancer into risk groups based on recurrence score, which are associated with distant recurrence and response to chemotherapy. This study aims to determine whether Oncotype DX influences clinicians' treatment decisions, and whether assay results correlate with histologic assessment. Fifty patients with estrogen-receptor positive, node-negative early breast cancer analyzed by Oncotype DX and operated on by two breast surgeons were included. To assess effect on treatment decisions, clinical vignettes were created by retrospective chart review. Physicians were then presented with the clinical vignettes and instructed to make a treatment decisions (i.e., hormone therapy alone versus hormone therapy combined with chemotherapy) both before and after knowledge of the recurrence score. To assess correlation with histologic assessment, a prospective, blinded review of tumor slides was performed by two pathologists. Based on this review, tumors were placed into low, intermediate and high risk groups for comparison with Oncotype DX assay results. Treatment decisions were changed based on Oncotype DX results in 36 and 18% of cases by breast surgeons and medical oncologists, respectively. All tumors categorized as high risk by Oncotype DX were categorized as high risk based on histologic assessment, and 96% of cases categorized as low risk by recurrence score were categorized as low or intermediate risk by histologic assessment. Oncotype DX significantly influences management of estrogen-receptor positive, lymph-node-negative early breast cancer. Further studies are needed to assess association of histologic categorization to assay results.