The D-Lab: Decision Support for Precision Medicine GROW - School for Oncology and Developmental Biology & MCCC, Maastricht University Medical Center, Maastricht, Netherlands.
Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands.
Biomed Res Int. 2019 Jun 6;2019:4961768. doi: 10.1155/2019/4961768. eCollection 2019.
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.
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.
Our search resulted in twelve diagnostic mDSS; six treatment mDSS; two patient mDSS; and eight papers that could improve mDSS.
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.
多因素决策支持系统(mDSS)是一种旨在改善临床决策过程的工具,它使用针对个体患者的临床输入来生成特定于病例的建议。本研究提供了对文献的概述,以分析目前针对前列腺癌(PCa)的可用 mDSS,以便更好地了解决策支持工具的可用性以及当前文献的不足之处。
我们于 2018 年 7 月进行了 MEDLINE 文献检索。我们将纳入的研究分为不同的部分:诊断部分,用于帮助检测或分期 PCa;治疗部分,支持治疗方式之间的决策;患者部分,重点是告知患者。我们手动筛选并排除了不包含有关前列腺癌和研究提案的 mDSS 的研究。
我们的搜索结果包括 12 个诊断 mDSS;6 个治疗 mDSS;2 个患者 mDSS;以及 8 篇可以改进 mDSS 的论文。
在文献中,诊断 mDSS 以及针对外束放射治疗的治疗 mDSS 都有很好的代表性;然而,其他治疗方式的 mDSS 却缺乏。患者决策辅助工具的开发是一个新的研究领域,针对 PCa 患者的成功案例很少。这些工具可以改进个性化医疗,但需要克服许多困难才能取得成功,并且需要更多的研究。