Why you should read this article:

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To understand how clinical decision support systems (CDSSs) can assist clinicians to achieve informed cancer treatment decisions

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To appreciate that CDSSs should not be used as a substitute for clinicians’ knowledge, competence and expertise

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To recognise that CDSSs should reflect the holistic, person-centred approach seen in contemporary cancer care

Decision-making in breast cancer treatment is a complex process. There is no certainty of the effects of a treatment regimen in a specific patient and the consequences of erroneous decisions can be serious or even fatal for the patient. Clinical decision support systems (CDSSs) are technology aids that have been progressively introduced in clinical practice to reduce decision errors and improve the quality of clinical decisions.

This article presents a critical review of the empirical literature on the use of CDSSs in breast cancer treatment decision-making. Three articles were included and two salient challenges identified in the design and research of CDSSs. First, there is a lack of standardisation in the tumour and patient factors and the health goals used to predict the benefit of different treatment options, as well as in the methods used for the evaluation of these. Second, the design of CDSSs follows a biomedical, disease-focused approach to healthcare, and this reductionist approach also prevails in the related scholarly literature.