Transformation of the National Breast Cancer Guideline Into Data-Driven Clinical Decision Trees Article Swipe
YOU?
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· 2019
· Open Access
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· DOI: https://doi.org/10.1200/cci.18.00150
PURPOSE The essence of guideline recommendations often is intertwined in large texts. This impedes clinical implementation and evaluation and delays timely modular revisions needed to deal with an ever-growing amount of knowledge and application of personalized medicine. The aim of this project was to model guideline recommendations as data-driven clinical decision trees (CDTs) that are clinically interpretable and suitable for implementation in decision support systems. METHODS All recommendations of the Dutch national breast cancer guideline for nonmetastatic breast cancer were translated into CDTs. CDTs were constructed by nodes, branches, and leaves that represent data items (patient and tumor characteristics [eg, T stage]), data item values (eg, T2 or less), and recommendations (eg, chemotherapy), respectively. For all data items, source of origin was identified (eg, pathology), and where applicable, data item values were defined on the basis of existing classification and coding systems (eg, TNM, Breast Imaging Reporting and Data System, Systematized Nomenclature of Medicine). All unique routes through all CDTs were counted to measure the degree of data-based personalization of recommendations. RESULTS In total, 60 CDTs were necessary to cover the whole guideline and were driven by 114 data items. Data items originated from pathology (49%), radiology (27%), clinical (12%), and multidisciplinary team (12%) reports. Of all data items, 101 (89%) could be classified by existing classification and coding systems. All 60 CDTs could be integrated in an interactive decision support app that contained 376 unique patient subpopulations. CONCLUSION By defining data items unambiguously and unequivocally and coding them to an international coding system, it was possible to present a complex guideline as systematically constructed modular data-driven CDTs that are clinically interpretable and accessible in a decision support app.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1200/cci.18.00150
- OA Status
- green
- Cited By
- 26
- References
- 25
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2946856592
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2946856592Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1200/cci.18.00150Digital Object Identifier
- Title
-
Transformation of the National Breast Cancer Guideline Into Data-Driven Clinical Decision TreesWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2019Year of publication
- Publication date
-
2019-05-29Full publication date if available
- Authors
-
Mathijs P. Hendriks, Xander Verbeek, Thijs van Vegchel, Maurice J.C. van der Sangen, Luc J. A. Strobbe, J. W. S. Merkus, Harmien M. Zonderland, Carolien H. Smorenburg, Agnes Jager, Sabine SieslingList of authors in order
- Landing page
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https://doi.org/10.1200/cci.18.00150Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/7101250Direct OA link when available
- Concepts
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Guideline, Coding (social sciences), Multidisciplinary approach, Breast cancer, Computer science, Personalization, Medicine, Medical physics, Data mining, Pathology, Cancer, Internal medicine, World Wide Web, Statistics, Social science, Sociology, MathematicsTop concepts (fields/topics) attached by OpenAlex
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26Total citation count in OpenAlex
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2025: 5, 2024: 4, 2023: 6, 2022: 3, 2021: 2Per-year citation counts (last 5 years)
- References (count)
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25Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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