Decision Support Systems in Prostate Cancer Treatment: An Overview

Abstract

Background. A multifactorial decision support system (mDSS) is a tool designed to improve the clinical decision-making process, while using clinical inputs for an individual patient to generate case-specific advice. The study provides an overview of the literature to analyze current available mDSS focused on prostate cancer (PCa), in order to better understand the availability of decision support tools as well as where the current literature is lacking. Methods. We performed a MEDLINE literature search in July 2018. We divided the included studies into different sections: diagnostic, which aids in detection or staging of PCa; treatment, supporting the decision between treatment modalities; and patient, which focusses on informing the patient. We manually screened and excluded studies that did not contain an mDSS concerning prostate cancer and study proposals. Results. Our search resulted in twelve diagnostic mDSS; six treatment mDSS; two patient mDSS; and eight papers that could improve mDSS. Conclusions. Diagnosis mDSS is well represented in the literature as well as treatment mDSS considering external-beam radiotherapy; however, there is a lack of mDSS for other treatment modalities. The development of patient decision aids is a new field of research, and few successes have been made for PCa patients. These tools can improve personalized medicine but need to overcome a number of difficulties to be successful and require more research.

Clinical Decision Support Systems in Breast Cancer: A Systematic Review

“…In answer to our first research question to identify and critically appraise the use of CDSSs in breast cancer and their targeted outcomes, clear evidence is seen in studies on the effectiveness of CDSSs in healthcare in general [20], and specifically, cardiovascular diseases [21], pulmonary disease [61], chronic wounds [62], drug prescribing [63] and prostate cancer treatment [64], among others. This type of evidence is also needed for CDSS tools specific to breast cancer treatment decision-making.…”

Covid19Risk.ai: An open source repository and online calculator of prediction models for early diagnosis and prognosis of Covid-19

“…The steps that we followed from the literature search until the final stage of publishing online are shown in Figure 1. In order to assess the reporting quality of the models from the studies, we tested each paper for its compliance to the TRIPOD (Transparent Reporting of studies on prediction models for Individual Prognosis Or Diagnosis) reporting guideline as shown in Figure 2 [10,12]. Figure 2-TRIPOD types classifications [10].…”

Multiparametric prostate MRI and structured reporting: benefits and challenges in the PI-RADS era

“…Clinical Decision Support Systems (CDSS) offer patientspecific advice based on guideline recommendations to enhance the process of decision-making by physicians and other healthcare practitioners, improve safety, and facilitate evidence-based practice. A multifactorial decision support system (mDSS) describes a tool which improves the clinical decision-making process by utilizing clinical inputs for an individual patient to generate case-specific therapy advice [79].…”

“…mDSS for diagnostic interventions aim to detect, diagnose, or classify PCa using various methods. Several prediction tools are currently used in clinics to support PCa diagnostics including analysis of potential LN involvement, organ confinement, seminal vesicle involvement, and extracapsular extension as well as the risk of failure after treatment [79].…”