Cancer, Computers and Complexity: Decision Making for the Patient

In health care, a trend may be noted to fundamentally question some of today’s assumptions about the traditional roles of medical disciplines, the doctor–patient relationship, the feasibility of medical studies, and about the role of computers as an aid or replacement of doctors. Diagnostics and therapy decision-making become more complex, and no end is in sight. Amounts of health-related data are being collected individually, and through the health care systems. On the example of breast cancer care, technological advances and societal changes can be observed as they take place concurrently, and patterns and hypotheses emerge that will be the focus of this article. In particular, three key changes are to be considered: (1) the growing appreciation of the uniqueness of diseases and the impact of this notion on the future of evidence-based medicine; (2) the acknowledgment of a ‘big data’ problem in today’s medical practice and science, and the role of computers; and (3) the societal demand for ‘P4 medicine’ (predictive, preventive, participatory, personalized), and its impact on the roles of doctors and patients.