{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:04:51Z","timestamp":1773993891291,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["101057389"],"award-info":[{"award-number":["101057389"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Breast cancer therapy improved significantly, allowing for different surgical approaches for the same disease stage, therefore offering patients different aesthetic outcomes with similar locoregional control. The purpose of the CINDERELLA trial is to evaluate an artificial-intelligence (AI) cloud-based platform (CINDERELLA platform) vs the standard approach for patient education prior to therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective randomized international multicentre trial comparing two methods for patient education prior to therapy. After institutional ethics approval and a written informed consent, patients planned for locoregional treatment will be randomized to the intervention (CINDERELLA platform) or controls. The patients in the intervention arm will use the newly designed web-application (CINDERELLA platform, CINDERELLA APProach) to access the information related to surgery and\/or radiotherapy. Using an AI system, the platform will provide the patient with a picture of her own aesthetic outcome resulting from the surgical procedure she chooses, and an objective evaluation of this aesthetic outcome (e.g., good\/fair). The control group will have access to the standard approach. The primary objectives of the trial will be i) to examine the differences between the treatment arms with regards to patients\u2019 pre-treatment expectations and the final aesthetic outcomes and ii) in the experimental arm only, the agreement of the pre-treatment AI-evaluation (output) and patient\u2019s post-therapy self-evaluation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>The project aims to develop an easy-to-use cost-effective AI-powered tool that improves shared decision-making processes. We assume that the CINDERELLA APProach will lead to higher satisfaction, better psychosocial status, and wellbeing of breast cancer patients, and reduce the need for additional surgeries to improve aesthetic outcome.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0289365","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T17:28:36Z","timestamp":1691083716000},"page":"e0289365","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["Evaluating the ability of an artificial-intelligence cloud-based platform designed to provide information prior to locoregional therapy for breast cancer in improving patient\u2019s satisfaction with therapy: The CINDERELLA trial"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-1869","authenticated-orcid":true,"given":"Orit","family":"Kaidar-Person","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-2829","authenticated-orcid":true,"given":"Marilia","family":"Antunes","sequence":"additional","affiliation":[]},{"given":"Jaime S.","family":"Cardoso","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-0508","authenticated-orcid":true,"given":"Oriana","family":"Ciani","sequence":"additional","affiliation":[]},{"given":"Helena","family":"Cruz","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2575-8729","authenticated-orcid":true,"given":"Rosa","family":"Di Micco","sequence":"additional","affiliation":[]},{"given":"Oreste D.","family":"Gentilini","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4744-9174","authenticated-orcid":true,"given":"Tiago","family":"Gon\u00e7alves","sequence":"additional","affiliation":[]},{"given":"Pedro","family":"Gouveia","sequence":"additional","affiliation":[]},{"given":"J\u00f6rg","family":"Heil","sequence":"additional","affiliation":[]},{"given":"Pawel","family":"Kabata","sequence":"additional","affiliation":[]},{"given":"Daniela","family":"Lopes","sequence":"additional","affiliation":[]},{"given":"Marta","family":"Martinho","sequence":"additional","affiliation":[]},{"given":"Henrique","family":"Martins","sequence":"additional","affiliation":[]},{"given":"Carlos","family":"Mavioso","sequence":"additional","affiliation":[]},{"given":"Martin","family":"Mika","sequence":"additional","affiliation":[]},{"given":"Helena","family":"Montenegro","sequence":"additional","affiliation":[]},{"given":"Helder P.","family":"Oliveira","sequence":"additional","affiliation":[]},{"given":"Andr\u00e9","family":"Pfob","sequence":"additional","affiliation":[]},{"given":"Nicole","family":"Rotmensz","sequence":"additional","affiliation":[]},{"given":"Timo","family":"Schink\u00f6the","sequence":"additional","affiliation":[]},{"given":"Giovani","family":"Silva","sequence":"additional","affiliation":[]},{"given":"Rosana","family":"Tarricone","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8137-3700","authenticated-orcid":true,"given":"Maria-Joao","family":"Cardoso","sequence":"additional","affiliation":[]},{"name":"on behalf of the CINDERELLA Consortium","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"issue":"3","key":"pone.0289365.ref001","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jviscsurg.2019.04.014","article-title":"From informed consent to shared decision-making in surgery","volume":"156","author":"K Slim","year":"2019","journal-title":"J Visc Surg"},{"issue":"4","key":"pone.0289365.ref002","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1111\/hex.13510","article-title":"Cocreation with Dutch patients of decision-relevant information to support shared decision-making about adjuvant treatment in breast cancer care","volume":"25","author":"IS van Strien-Knippenberg","year":"2022","journal-title":"Health Expect"},{"issue":"10","key":"pone.0289365.ref003","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1016\/j.annonc.2021.06.023","article-title":"Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021. 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