###### Abstract  
Background: When a patient presents with localized prostate cancer, referral for radiation oncology consultation includes a discussion of likely outcomes of therapy. Among current radiation treatments for prostate cancers, hypo-fractionated stereotactic body radiation therapy (SBRT) has gained clinical acceptance based on efficacy, short duration of treatment, and the potential radiobiological advantages. The Prostate Clinical Outlook Visualization System (PCOVS) was developed to provide the patient and the clinician with a tool to visualize probable treatment outcomes using institutional, patient specific data for comparing results of treatment. Methods: We calculated the prostate cancer outcomes--for each prospective patient using the EPIC-26 quality of life parameters based on clinical outcomes data of 580 prostate cancer patients who were treated with SBRT. We applied Kaplan-Meier analysis using the ASTRO definition for biochemical recurrence (BCR) free survival and likely outcome and the PCOVS nomogram to calculate parameters for quality of life. Open-source R, RShiny, and MySQL were used to develop a modularized architecture system. Results: The PCOVS presents patient specific risk scores in a gauge chart style and risk free probability bar plots to compare the treatment data of patients treated with SBRT. The PCOVS generates reports, in PDF, which consists of a comparison charts of risk free probabilities late effects and gauge charts of risk scores. This system is now being expanded as a web-based service to patients. Conclusions: The PCOVS visualized patient specific likely outcomes were compared to treatment data from a single department, helping the patient and the clinician to visualize likely outcomes. The PCOVS approach can be expanded to other specialties of oncology with the flexible, modularized architecture, which can be customized by changing independent modules. Keywords:visualization; clinical decision support system; prostate cancer; stereotactic body radiation therapy +
Footnote †: journal: Medical Informatics, Medical Inform  
future status and likely outcomes. If the physician can tell the patients about their future status with specific graphically-based data-driven outcomes, then patients can understand more and be adherent to the treatment and their future status. It is useful to help patients understand their therapy and likely outcomes. It gives prostate patients confidence in their treatment. Therefore, explanations need to focus on practical localized data that explains likely outcomes. In addition, the physician can proffer confidence when communicating likely outcomes to their patients with the assistance of practical data. At present, the time required for a Radiation Oncologist to analyze an individual patient's pathology and to then convey meaningful information can be burdensome. It would be beneficial if a physician could have ready access to explanatory information that included graphical displays that deal with a single patient's disease. A point of care clinical decision support system (CDSS) is needed to support patients, save effort and time, and allow the physician to focus on their patients. CDSS is a knowledge-based system for decision-making in routine clinical use. CDSS offers potential benefits, such as improved patient safety, improved quality of care, and improved efficiency in health care delivery [3]. If the CDSS can display easy to read clinical results, then it helps people to understand and use statistic results. The CDSS should make a better environment for both prostate cancer patients and physicians with a single mouse click, resulting in an outcome result visualization report. To create the CDSS, we focused on localized hypo-fractionated stereotactic body radiation therapy (SBRT) data, as SBRT has shown significant improvements for prostate cancer treatment. Among current treatments for prostate cancers, SBRT has gained clinical acceptance based on efficacy, short duration of treatment, and radiobiological advantages [4].