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The scheduling of clinical pathways such as oncological treatments involves a tricky decision process because the therapeutic regimens require to respect strict timing constraints with possibly limited resources such as beds and caregivers availability with an increasing number of patients. Such constraints must be met simultaneously for every patient treated at the same time, by making the best use of limited hospital resources. The scheduling must also be robust in case of adverse events such as unexpected delays or partial treatment deliveries due to their toxicity. In this paper, we show how such a decision process can be driven by care quality indicators to ensure all the dimensions. We demonstrate how constraint-based local search techniques can cope with real-world size chemotherapy pathways and efficiently adapt to changes. We also share some ethical concerns about the way the objective function is expressed and more generally about how the tool integrates in the medical decision process.

Decision Making Support in the Scheduling of Chemotherapy Coping with Quality of Care, Resources and Ethical Constraints