ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
This article is part of the Research TopicEmerging Diagnostic and Therapeutic Strategies for Urological CancersView all 5 articles
Monitoring Prostate Cancer under Androgen-Deprivation Therapy: Insights from the Implementation of a Clinical Decision Support System Dashboard
Provisionally accepted
Álvaro Martínez Pérez1
Gonzalo Collantes2José Luis Ruíz-Cerdà3,4Antonio Conde-Moreno3Regina Gironés3
Beatriz Garcillán5
Julià Amengual1*
María Eugenia Gas1*- 1Plataforma de Big Data, IA, Bioestadística y Bioinformática, La Fe Health Research Institute, Valencia, Spain
- 2La Fe Health Research Institute, Valencia, Spain
- 3Hospital Universitari i Politecnic La Fe, Valencia, Spain
- 4Universitat de Valencia Departament de Medicina, Valencia, Spain
- 5Medical Affairs Department, Johnson & Johnson, Madrid, Spain
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Clinical Decision Support Systems (CDSS) are technologies intended to assist clinicians in making informed decisions based on comprehensive data and clinical guidelines. CDSSs have the potential to improve the quality and consistency of cancer care by promoting evidence-based decision-making and timely recognition of key-performance indicators during disease follow-up. In prostate cancer (PC), particularly for patients undergoing androgen deprivation therapy (ADT), early identification of castration-resistant prostate cancer (CRPC) and proper surveillance of biomarkers of disease progression are critical. This study aimed to evaluate the impact of a CDSS on the monitoring and clinical management of advanced PC patients in a hospital setting. A retrospective, single-centre cohort study was conducted using patient-level structured data obtained from the institutional Data Warehouse of Hospital La Fe (Valencia, Spain). The study population comprised patients diagnosed with PC who received ADT, analysed across two consecutive one-year periods, from 15th September 2021 to 14th September 2022 (pre-implementation) and from 15th September 2022 to 15th September 2023 (post-implementation of the CDSS). Primary outcomes included the proportion of patients identified with CRPC, classification of PSA kinetics instability, and the use of palliative radiotherapy. CDSS implementation was associated with higher detection rates of CRPC, which increased from 20.7% to 27.9%, while the post‑implementation proportion with unstable PSA kinetics was higher (81.1% vs 64.7%; p = 0.01). The change in the use of palliative radiotherapy did not reach statistical significance; however, data showed a modest increase (from 11.7% to 15.1%). CDSS deployment was associated with improved monitoring signals and earlier recognition of disease progression in ADT-treated patients. The system was associated with stronger PSA-based risk stratification and more timely multidisciplinary coordination. While some trends require confirmation through longer follow-up and broader implementation, these findings support the role of digital tools in optimizing routine PC management.
Keywords: castration‑resistant prostate cancer, clinicaldecision support system (CDSS), Dashboard, prostate cancer, PSA, valued-based medicine
Received: 14 Nov 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Pérez, Collantes, Ruíz-Cerdà, Conde-Moreno, Gironés, Garcillán, Amengual and Gas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Julià Amengual
María Eugenia Gas
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