## 3 Discussion  
We designed PROMISE CLIP and initiated a multicenter, big data study to develop PCa SW for patients and physicians. Based on our findings, we drew the following conclusions. First, PROMISE CLIP is a large-scale project for developing a Korean precision medicine service. PROMISE CLIP is one project of Intelligent SW Technology Development for Medical Data Analysis by National IT Industry Promotion Agency (NIPA): Dr. Answer. It established a consortium of Korean Data and Software-driven Hospital Consortium (K-Dash) in 2018 ([[http://dranswer.kr](http://dranswer.kr)]([http://dranswer.kr](http://dranswer.kr))). K-Dash consists of 25 hospitals and 19 companies for eight diseases: cardiocerebrovascular disease, cardiac disorder, breast cancer, colorectal cancer, PCa, dementia, epilepsy, and childhood genetic and rare diseases. Among the eight diseases, PROMISE CLIP is meaningful as a multicenter project for PCa ([[http://dranswer.kr/disease/cancer1.php?tab=2](http://dranswer.kr/disease/cancer1.php?tab=2)]([http://dranswer.kr/disease/cancer1.php?tab=2](http://dranswer.kr/disease/cancer1.php?tab=2))). Second, PROMISE CLIP developed a large-scale registry based on clinical, imaging, and pathology data from four tertiary hospitals. We put significant effort into gathering large-scale clinical, imaging, and pathology data. It is difficult to develop a registry with controlled clinical, imaging, and pathology data. Integration of data sources in hospitals is important and has challenges that need to be overcome [11]. We cooperated in harmony to develop the PROMISE CLIP registry. Collection of biopsy and prostatectomy biospecemens is an ideal characteristic of PCa registries [7]. The Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) had plans to collect biospecemens from both prostate biopsies and radical prostatectomies [12]. Diverse registries for PCa have been published and exert a growing role in advancing PCa research and care: CaPSURE [12], the Michigan Unological Surgery Improvement Collaborative (MUSIC) [13], and the Victorian Prostate Cancer Registry (PCR) [14]. In addition, the PROMISE CLIP registry has sufficient follow-up data for clinically relevant endpoints. Accordingly, the PROMISE CLIP registry has advantages for diverse AI projects and unsolved medical demands in PCa. Third, the PROMISE CLIP project is meaningful for both PCa patients and clinicians because we expect intelligent SW for PCa. These SW help patients and clinicians decide the best treatment option. (1) The first SW is about the prediction of pathologic outcomes and treatment outcomes after definitive surgery that helps patients and clinicians decide the best treatment option. (2) The second SW is about visualization of treatment course with valuable markers that help to define the ideal patient population for aggressive follow-up or early postoperative ancillary treatment. (3) The third SW automatically generates accurate interpretation of multiparametric MRI. (4) The last SW is about accurate digital pathology of PCa to improve accuracy, reduce human error, and increase reproducibility. These SWs are described in detail below. The first SW provides prediction of clinical stage based on machine learning from Korean EMR data. The SW will show the prediction of pathologic outcomes, biochemical recurrence, and survival rate using visualization library technology. We have plans to develop an Open API to provide a related service. LifeSemantics Corp. has contributed to the development of the first SW, who developed an mHealth management platform for patients [15; 16]. The second SW provides visualization and calculation functionalities for an optimized view of PCa patient information. Clinicians access the most recent information at the right time to make treatment decisions. This SW is going to include treatment suggestions using machine learning algorithms. Seoul St. Mary's Hospital has contributed to the development of the second SW. The third SW automatically generates diagnosis information from MRI images.