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Data-driven support to decision-making in molecular tumour boards for lymphoma: A design science approach
Karolinska Inst, Hlth Informat Ctr, Dept Learning Informat Management & Ethics LIME, Stockholm, Sweden..
Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.;Karolinska Univ Hosp Huddinge, Dept Lab Med, Div Pathol, Stockholm, Sweden..
Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden..
Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden..
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2022 (English)In: Frontiers in Oncology, E-ISSN 2234-943X, Vol. 12, article id 984021Article in journal (Refereed) Published
Abstract [en]

Background: The increasing amount of molecular data and knowledge about genomic alterations from next-generation sequencing processes together allow for a greater understanding of individual patients, thereby advancing precision medicine. Molecular tumour boards feature multidisciplinary teams of clinical experts who meet to discuss complex individual cancer cases. Preparing the meetings is a manual and time-consuming process. Purpose: To design a clinical decision support system to improve the multimodal data interpretation in molecular tumour board meetings for lymphoma patients at Karolinska University Hospital, Stockholm, Sweden. We investigated user needs and system requirements, explored the employment of artificial intelligence, and evaluated the proposed design with primary stakeholders. Methods: Design science methodology was used to form and evaluate the proposed artefact. Requirements elicitation was done through a scoping review followed by five semi-structured interviews. We used UML Use Case diagrams to model user interaction and UML Activity diagrams to inform the proposed flow of control in the system. Additionally, we modelled the current and future workflow for MTB meetings and its proposed machine learning pipeline. Interactive sessions with end-users validated the initial requirements based on a fictive patient scenario which helped further refine the system. Results: The analysis showed that an interactive secure Web-based information system supporting the preparation of the meeting, multidisciplinary discussions, and clinical decision-making could address the identified requirements. Integrating artificial intelligence via continual learning and multimodal data fusion were identified as crucial elements that could provide accurate diagnosis and treatment recommendations. Impact: Our work is of methodological importance in that using artificial intelligence for molecular tumour boards is novel. We provide a consolidated proof-of-concept system that could support the end-to-end clinical decision-making process and positively and immediately impact patients. Conclusion: Augmenting a digital decision support system for molecular tumour boards with retrospective patient material is promising. This generates realistic and constructive material for human learning, and also digital data for continual learning by data-driven artificial intelligence approaches. The latter makes the future system adaptable to human bias, improving adequacy and decision quality over time and over tasks, while building and maintaining a digital log.

Place, publisher, year, edition, pages
Frontiers Media SA , 2022. Vol. 12, article id 984021
Keywords [en]
precision medicine, next-generation sequencing, molecular tumour board, clinical decision support system, artificial intelligence, multimodal data, lymphoma
National Category
Cancer and Oncology Bioinformatics (Computational Biology)
Identifiers
URN: urn:nbn:se:kth:diva-322857DOI: 10.3389/fonc.2022.984021ISI: 000892257300001PubMedID: 36457495Scopus ID: 2-s2.0-85143118784OAI: oai:DiVA.org:kth-322857DiVA, id: diva2:1724686
Note

QC 20230109

Available from: 2023-01-09 Created: 2023-01-09 Last updated: 2024-01-17Bibliographically approved

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Boman, Magnus

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