Background: Cancer patients frequently face intricate treatment choices, each presenting unique risk profiles and impacts on both survival rates and overall life quality. Furthermore, inefficiencies in current care pathways can hinder effective shared decision-making between patients and healthcare providers. Data-driven decision-support tools offer a promising avenue to empower patients, personalize care approaches, enhance health outcomes, and advance health equity. However, existing decision-support tools often fall short by not adequately considering quality of life aspects or individual patient preferences. Their integration into routine clinical practice remains limited, partly due to a lack of seamless integration within patient care pathways.
Aim and objectives: The core mission of the 4D PICTURE project is to fundamentally redesign patient care pathways and to create and integrate evidence-based decision-support tools to optimize decision-making processes throughout cancer care delivery. This article provides a comprehensive overview of this ambitious international and interdisciplinary initiative focused on implementing effective Care Redesign Tools.
Design methods and analysis: Through a collaborative co-creation approach involving patients and various stakeholders, we are developing data-driven decision-support tools specifically tailored for patients diagnosed with breast cancer, prostate cancer, and melanoma. These care redesign tools will facilitate informed treatment decisions by leveraging extensive, high-quality datasets combined with cutting-edge prognostic algorithms. To further enhance patient-centered care, we are developing an innovative conversation aid called the Metaphor Menu. This tool utilizes text mining techniques, citizen science contributions, and linguistic analysis to incorporate vast datasets of patient experiences, values, and preferences. Crucially, we are advancing MetroMapping, a highly promising methodology for the effective redesign of care pathways. The 4D PICTURE project will rigorously evaluate both MetroMapping and the integrated decision-support tools, ensuring their long-term sustainability through the application of the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework. Moreover, we will investigate the broader applicability of MetroMapping and the decision-support tools to other cancer types and across diverse healthcare systems within EU member states.
Ethics: An embedded ethics approach is central to our project, ensuring proactive and thorough consideration of social and ethical implications throughout the development and implementation of these care redesign tools.
Discussion: Enhanced care pathways, incorporating comprehensive decision-support tools, hold significant potential to empower patients, their families, and healthcare providers in shared decision-making processes, ultimately leading to improved patient outcomes. This project aims to strengthen healthcare systems at a fundamental level by enhancing both their resilience and efficiency through the strategic application of care redesign tools.
