ArticleBritish journal of cancer2013
Which breast cancer decisions remain non-compliant with guidelines despite the use of computerised decision support?
Article in British journal of cancer, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Leveraging artificial intelligence to support surgical oncology multidisciplinary team decision-making: a systematic review.Frontiers in artificial intelligence · 2026Pooled it
- Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review.Implementation science : IS · 2023Pooled it
- Pooled it
- Healthcare providers' adherence to breast cancer guidelines in Europe: a systematic literature review.Breast cancer research and treatment · 2020Pooled it
- Use of Routine Health Datasets to Assess the Appropriateness of Diagnostic Tests in the Follow-Up of Breast Cancer Patients: A Population-Based Study on 3930 Patients.Risk management and healthcare policy · 2022Article
- Preliminary Qualitative and Quantitative Evaluation of DESIREE, a Decision Support Platform for the Management of Primary Breast Cancer Patients.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2020Article
- Multidisciplinary care of breast cancer patients: a scoping review of multidisciplinary styles, processes, and outcomes.Current oncology (Toronto, Ont.) · 2019Article
- Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.Translational oncology · 2018Article
- Clinical practice guidelines in breast cancer.Current oncology (Toronto, Ont.) · 2018Review
- Reconciliation of multiple guidelines for decision support: a case study on the multidisciplinary management of breast cancer within the DESIREE project.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2017Article
- Guideline conformity treatment in young women with early-onset breast cancer in Germany.Breast care (Basel, Switzerland) · 2014Article
- A 2014 medical informatics perspective on clinical decision support systems: do we hit the ceiling of effectiveness?Yearbook of medical informatics · 2014Review
- An Algorithm Using Twelve Properties of Antibiotics to Find the Recommended Antibiotics, as in CPGs.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2014Article
- Health information technology: use it well, or don't! Findings from the use of a decision support system for breast cancer management.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2014Article
- Artificial intelligence in oncology: Current status and possibilities (Review).Medicine internationalReview
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite multidisciplinary tumour boards (MTBs), non-compliance with clinical practice guidelines is still observed for breast cancer patients. Computerised clinical decision support systems (CDSSs) may improve the implementation of guidelines, but cases of non-compliance persist.
methodsOncoDoc2, a guideline-based decision support system, has been routinely used to remind MTB physicians of patient-specific recommended care plans. Non-compliant MTB decisions were analysed using a multivariate adjusted logistic regression model.
resultsBetween 2007 and 2009, 1624 decisions for invasive breast cancers with a global non-compliance rate of 8.3% were analysed. Patient factors associated with non-compliance were age>80 years (odds ratio (OR): 7.7; 95% confidence interval (CI): 3.7-15.7) in pre-surgical decisions; microinvasive tumour (OR: 5.2; 95% CI: 1.5-17.5), surgical discovery of microinvasion in addition to a unique invasive tumour (OR: 4.2; 95% CI: 1.4-12.5), and prior neoadjuvant treatment (OR: 4.2; 95% CI: 1.1-15.1) in decisions with recommendation of re-excision; age<35 years (OR: 4.7; 95% CI: 1.9-11.4), positive hormonal receptors with human epidermal growth factor receptor 2 overexpression (OR: 15.7; 95% CI: 3.1-78.7), and the absence of prior axillary surgery (OR: 17.2; 95% CI: 5.1-58.1) in adjuvant decisions.
conclusionResidual non-compliance despite the use of OncoDoc2 illustrates the need to question the clinical profiles where evidence is missing. These findings challenge the weaknesses of guideline content rather than the use of CDSSs.
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