title: Decision support systems for personalized and participative radiation oncology.
abstract: A paradigm shift from current population based medicine to personalized and participative medicine is underway. This transition is being supported by the development of clinical decision support systems based on prediction models of treatment outcome. In radiation oncology, these models 'learn' using advanced and innovative information technologies (ideally in a distributed fashion - please watch the animation: http://youtu.be/ZDJFOxpwqEA) from all available/appropriate medical data (clinical, treatment, imaging, biological/genetic, etc.) to achieve the highest possible accuracy with respect to prediction of tumor response and normal tissue toxicity. In this position paper, we deliver an overview of the factors that are associated with outcome in radiation oncology and discuss the methodology behind the development of accurate prediction models, which is a multi-faceted process. Subsequent to initial development/validation and clinical introduction, decision support systems should be constantly re-evaluated (through quality assurance procedures) in different patient datasets in order to refine and re-optimize the models, ensuring the continuous utility of the models. In the reasonably near future, decision support systems will be fully integrated within the clinic, with data and knowledge being shared in a standardized, dynamic, and potentially global manner enabling truly personalized and participative medicine.
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands. Electronic address: philippe.lambin@maastro.nl.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Zindler
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ben G L
authors.initials: BG
authors.lastname: Vanneste
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Lien Van
authors.initials: LV
authors.lastname: De Voorde
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Eekers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Compter
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Kranthi Marella
authors.initials: KM
authors.lastname: Panth
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Peerlings
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ruben T H M
authors.initials: RT
authors.lastname: Larue
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Timo M
authors.initials: TM
authors.lastname: Deist
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Arthur
authors.initials: A
authors.lastname: Jochems
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Lustberg
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: van Soest
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Evelyn E C
authors.initials: EE
authors.lastname: de Jong
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Aniek J G
authors.initials: AJ
authors.lastname: Even
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Reymen
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Nicolle
authors.initials: N
authors.lastname: Rekers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Marike
authors.initials: M
authors.lastname: van Gisbergen
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Roelofs
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Sara
authors.initials: S
authors.lastname: Carvalho
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ralph T H
authors.initials: RT
authors.lastname: Leijenaar
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Catharina M L
authors.initials: CM
authors.lastname: Zegers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Jacobs
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Janita
authors.initials: J
authors.lastname: van Timmeren
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Patricia
authors.initials: P
authors.lastname: Brouwers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Lal
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Dubois
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ala
authors.initials: A
authors.lastname: Yaromina
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Evert Jan
authors.initials: EJ
authors.lastname: Van Limbergen
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Berbee
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: van Elmpt
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Cary
authors.initials: C
authors.lastname: Oberije
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: Ramaekers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Andre
authors.initials: A
authors.lastname: Dekker
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Liesbeth J
authors.initials: LJ
authors.lastname: Boersma
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Hoebers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Smits
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: Berlanga
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Sean
authors.initials: S
authors.lastname: Walsh
mesh_terms: D020000:Decision Support Systems, Clinical; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D057285:Precision Medicine / Q000379:methods*; D018787:Radiation Oncology / Q000379:methods*; D016896:Treatment Outcome
keywords: Decision support systems; Prediction models; Radiotherapy; Shared decision making