Evidence map›Paper›PMID 42256337›Full record

ArticleBMJ oncology2026

Bayesian networks as prognostic models in oncology: a systematic review and recommendations for clinical practice.

Casper Reijnen, Johanna M A Pijnenborg, Peter Hoskin, Alan Mcwilliam, Peter J F Lucas, Arjen Hommersom, Johan Kwisthout, Ananya Choudhury

Abstract read
In one paragraph

Article in BMJ oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Casper ReijnenDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID https://orcid.org/0000-0001-6873-7832
Johanna M A PijnenborgDepartment of Obstetrics and Gynecology, Radboud university medical center, Nijmegen, The Netherlands.
Peter HoskinMount Vernon Cancer Centre, Northwood, UK.ORCID https://orcid.org/0000-0001-8323-9567
Alan McwilliamDivision of Cancer Sciences, University of Manchester; CRUK Manchester Institute; CRUK Manchester Centre, Manchester, UK.ORCID https://orcid.org/0000-0002-7344-2868
Peter J F LucasDepartment of Data Science, University of Twente, Enschede, The Netherlands.
Arjen HommersomDepartment of Computer Science, Open University, Heerlen, The Netherlands.
Johan KwisthoutDonders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
Ananya ChoudhuryDivision of Cancer Sciences, University of Manchester; CRUK Manchester Institute; CRUK Manchester Centre, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: In the last decades, artificial intelligence has made tremendous steps in supporting decision-making in healthcare. Bayesian networks (BNs) have emerged as powerful tools for probabilistic modelling and offer important advantages compared with regression-based models. This systematic review identifies the available literature on BNs for prognostication in oncology, evaluates their performance and discusses how BNs can overcome limitations of traditional prediction models. Design setting participants: The systematic review was performed according to the Cochrane guidance and reported according to the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The protocol was registered in PROSPERO. Studies identified in MEDLINE and EMBASE were included. Main outcome measures: Eligible studies investigated BNs as Results: A total of 52 studies were included, with a median construction cohort size of 438 patients. More than half of studies harboured unclear or high concerns about bias. Most studies used score-based structure learning approaches to construct the BNs. External validation was applied in a minority of studies and showed excellent performance metrics when hybrid techniques (integration of machine-learning and expert knowledge) were applied. Studies comparing BN validation with Cox regression validation showed better performance for BNs in most studies. Conclusions: When constructed with hybrid techniques, BNs offer great potential to support decision-making in clinical oncology. Advantages include their ability to estimate treatment effects with non-randomised data, to model causal relationships, to apply counterfactual reasoning and to work with missing variables. To be implemented into clinical practice, hybrid construction techniques, high-quality external validation, prospective evaluation with a health technology assessment and adequate postmarketing surveillance and maintenance are essential. PROSPERO registration number: CRD420251140130.

Indexed as

BiomarkersMortalitySolid tumourSurvival AnalysisTumour biomarkers

Identifiers

PMID42256337
PMCPMC13239501

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.