Decision Support and Information Management System for Breast Cancer

Breast cancer is the most common cancer in women worldwide, with around 1.7 million new cases every year, and it is a complex disease. Each case is usually discussed in multidisciplinary teams or committees, called Breast Units (BUs). BUs base their recommendations on the Clinical Practice Guidelines (CPGs), as they rely on the rigorous evaluation of scientific publications to provide best health care practices. Nevertheless, CPGs have some weaknesses, such as (i) incompleteness of recommendations, (ii) the fact that CPGs may lag behind the last medical evidence and (iii) the non-inclusion of some parameters crucial in the decision-making process, such as patient preferences or clinician preferences.

To overcome with these limitations and support BUs in their decision-making process a tool that not only implements CPGs but also complements them with additional information has been developed, called DESIREE (http://www.desiree-project.eu/). DESIREE is composed by three integrated and interactive Clinical Decision Support Systems (CDSSs), that besides implementing international and national CPGs, also provide similar patient cases information and stores and process all the relevant information involved in the decision-making process. This way when the BUs are non-compliant with the recommendations from the CPGs, new experience-based rules are generated, which are later validated by the collected treatment outcomes. This way the CPGs are augmented with new knowledge over time, supporting the clinical cases that are not present in current guidelines.

Additionally, DESIREE is composed by image-based breast and tumour characterization tools that extract biomarkers from patient’s images and make 3D breast reconstruction using predictive models.

Vicomtech besides coordinating this EU Horizon 2020 project, is leads the development of the CDSS, and, in particular, contributes in the development of the experience based CDSS, since its experience and expertise developing CDSSs has supported this work. Additionally, Vicomtech is one of the major participants for breast and tumor characterization within the project and collaborates on other tools, such as 3D breast reconstruction tool together with Houston Methodist.

DESIREE is being implemented in four European hospitals: Onkologikoa, ERESA, and Saint-Louis and George Pompidou Hospitals from Assistance publique – Hôpitaux de Paris (AP-HP), and it is being validated with more than 1000 cases. It is expected that the system not only supports clinicians in their decision making, but also generates new knowledge that can be explored with advanced visual analytics tools and provides personalized treatments.

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 690238.