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International Journal of Medical Sciences And Clinical Research

Peer Reviewed | Open Access | E-ISSN: 2771-2265
Published Article

Integrated Multidisciplinary and Intelligent Decision Support for Complex Chronic Care: A Comparative Review of Allergic Rhinitis–Asthma Comorbidity and Contemporary Oncology Practice

Integrated Multidisciplinary and Intelligent Decision Support for Complex Chronic Care: A Comparative Review of Allergic Rhinitis–Asthma Comorbidity and Contemporary Oncology Practice

Authors

  • Dr. Amelia Sørensen
    Department of Clinical Health Systems, University of Copenhagen, Denmark

Keywords:

Allergic rhinitis asthma comorbidity multidisciplinary care

Abstract

Background: Contemporary clinical care increasingly confronts diseases that are biologically complex, clinically heterogeneous, and operationally demanding. Two areas exemplify this challenge in particularly distinct yet conceptually related ways: allergic rhinitis with comorbid asthma, and cancer management through multidisciplinary tumor boards. The literature on allergic airway disease shows that rhinitis and asthma are strongly interconnected at epidemiological, immunological, symptomatic, and quality-of-life levels, requiring coordinated diagnostic and therapeutic approaches (Leynaert et al., 2000; Kalpaklioğlu & Baççioğlu, 2008; Bousquet et al., 2020; GINA, 2023). Meanwhile, oncology literature demonstrates that multidisciplinary decision-making has become central to patient-centered, precision-oriented management, with recent studies exploring the role of artificial intelligence and large language models as adjunctive tools in tumor boards and cancer care (Luchini et al., 2020; Benary et al., 2023; Sorin et al., 2023; Uprety et al., 2023).

Objective: This article develops an integrative review of how multidisciplinary practice, decision support, and patient-centered outcome assessment can improve management in two major clinical domains: allergic rhinitis–asthma comorbidity and oncology. It also critically evaluates the emerging role of artificial intelligence-based systems in complex clinical decision environments.

Methodology: A qualitative integrative review was conducted strictly on the basis of the references supplied. The study synthesized literature across epidemiology, pathophysiology, guideline-based care, quality of life, environmental and genetic risk, tumor board practice, Bayesian and AI-assisted decision systems, and large language model applications in healthcare.

Results: The review identifies four major findings. First, allergic rhinitis and asthma should be approached as linked airway disorders requiring coordinated evaluation. Second, disease burden extends beyond symptoms to productivity, function, psychosocial well-being, and treatment complexity. Third, multidisciplinary structures improve decision quality in oncology and provide a transferable model for other complex conditions. Fourth, artificial intelligence and large language models show promise as support tools, but their use remains constrained by concerns around reliability, contextual reasoning, bias, and governance.

Conclusion: The future of complex chronic care lies in combining evidence-based guidelines, multidisciplinary collaboration, nuanced phenotyping, and carefully governed intelligent decision support. The clinical promise of such integration is substantial, but it must remain grounded in human oversight, patient context, and rigorous validation.

References

Banjar, S. A., Assiri, R. A., Alshehri, G. A., Binyousef, F. H., Alaudah, T. I., & Alawam, A. S., et al. (2023). The impact of allergic rhinitis on asthma and its effect on the quality of life of asthmatic patients. Cureus, 15(3), e35714.

Berardi, R., Morgese, F., Rinaldi, S., Torniai, M., Mentrasti, G., Scortichini, L., et al. (2020). Benefits and limitations of a multidisciplinary approach in cancer patient management. Cancer Management and Research, 12, 9363–9374. https://doi.org/10.2147/cmar.s220976

Benary, M., Wang, X. D., Schmidt, M., Soll, D., Hilfenhaus, G., Nassir, M., et al. (2023). Leveraging large language models for decision support in personalized oncology. JAMA Network Open, 6(11), e2343689. https://doi.org/10.1001/jamanetworkopen.2023.43689

Bousquet, J., Schünemann, H. J., Togias, A., Bachert, C., Erhola, M., Hellings, P. W., et al. (2020). Next-generation allergic rhinitis and its impact on asthma (ARIA) guidelines. Journal of Allergy and Clinical Immunology, 145(1), 70–80.e3.

Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018. CA: A Cancer Journal for Clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492

Cascella, M., Montomoli, J., Bellini, V., & Bignami, E. (2023). Evaluating the feasibility of ChatGPT in healthcare. Journal of Medical Systems, 47(1). https://doi.org/10.1007/s10916-023-01925-4

Chen, Y., Dales, R., Tang, M., & Krewski, D. (2002). Obesity may increase asthma incidence in women. American Journal of Epidemiology, 155(3), 191–197.

Cypko, M. A., Stoehr, M., Oeltze-Jafra, S., Dietz, A., & Lemke, H. U. (2017). A guide for constructing Bayesian network graphs of cancer treatment decisions. MEDINFO 2017. https://doi.org/10.3233/978-1-61499-830-3-1355

Elkholy, M. M., Khedr, M. H., Halawa, A., & Elbaramawy, A. (2012). Impact of allergic rhinitis on quality of life in patients with bronchial asthma. International Journal of Health Sciences, 6(2), 194–202.

Fahy, J. V. (2009). Eosinophilic and neutrophilic inflammation in asthma: Insights from clinical studies. Proceedings of the American Thoracic Society, 6(3), 256–259.

GINA. (2023). Global strategy for asthma management and prevention. https://ginasthma.org/2023-gina-main-report/

Hossenbaccus, L., Linton, S., Garvey, S., & Ellis, A. K. (2020). Towards definitive management of allergic rhinitis: Best use of new and established therapies. Allergy, Asthma & Clinical Immunology, 16(1), 39.

Hügle, T. (2023). The wide range of opportunities for large language models such as ChatGPT in rheumatology. RMD Open, 9(2), e003105.

Ierodiakonou, D., Zanobetti, A., Coull, B. A., Melly, S., Postma, D. S., Boezen, H. M., et al. (2016). Ambient air pollution, lung function, and airway responsiveness in asthmatic children. Journal of Allergy and Clinical Immunology, 137(2), 390–399.

Jaakkola, M. S., Piipari, R., Jaakkola, N., & Jaakkola, J. J. (2003). Environmental tobacco smoke and adult-onset asthma: A population-based incident case-control study. American Journal of Public Health, 93(12), 2055–2060.

Kalmarzi, R. N., Khazaei, Z., Shahsavar, J., Gharibi, F., Tavakol, M., Khazaei, S., et al. (2017). The impact of allergic rhinitis on quality of life: A study in western Iran. Biomedical Research and Therapy, 4(9), 1629–1637.

Kalpaklioğlu, A. F., & Baççioğlu, A. (2008). Evaluation of quality of life: Impact of allergic rhinitis on asthma. Journal of Investigational Allergology and Clinical Immunology, 18(3), 168–173.

Kanchongkittiphon, W., Mendell, M. J., Gaffin, J. M., Wang, G., & Phipatanakul, W. (2015). Indoor environmental exposures and exacerbation of asthma: An update to the 2000 review by the Institute of Medicine. Environmental Health Perspectives, 123(1), 6–20.

Leynaert, B., Neukirch, C., Liard, R., Bousquet, J., & Neukirch, F. (2000). Quality of life in allergic rhinitis and asthma: A population-based study of young adults. American Journal of Respiratory and Critical Care Medicine, 162(4 Pt 1), 1391–1396.

Luchini, C., Lawlor, R. T., Milella, M., & Scarpa, A. (2020). Molecular tumor boards in clinical practice. Trends in Cancer, 6(9), 738–744. https://doi.org/10.1016/j.trecan.2020.05.008

Maoua, M., Maalel, O. E., Kacem, I., Guedri, S., Ben Kacem, M., Aissa, S., et al. (2019). Quality of life and work productivity impairment of patients with allergic occupational rhinitis. Tanaffos, 18(1), 58–65.

Meltzer, E. O., & Bukstein, D. A. (2011). The economic impact of allergic rhinitis and current guidelines for treatment. Annals of Allergy, Asthma & Immunology, 106(2 Suppl), S12–S16.

Moffatt, M. F., Gut, I. G., Demenais, F., Strachan, D. P., Bouzigon, E., Heath, S., et al. (2010). A large-scale, consortium-based genomewide association study of asthma. New England Journal of Medicine, 363(13), 1211–1221.

Moitra, S., Simoni, M., Baldacci, S., Maio, S., Angino, A., Silvi, P., et al. (2023). Symptom control and health-related quality of life in allergic rhinitis with and without comorbid asthma: A multicentre European study. Clinical and Translational Allergy, 13(2), e12209.

Monga, S., Malik, J., Sharma, A. P., Jan, S., Nabi, N., & Bahadur, S. (2019). Deranged pulmonary function tests in allergic rhinitis in North Indian patients. Clinical Medicine Insights: Ear, Nose and Throat, 12, 1179550619888856.

Nathan, R. A., Meltzer, E. O., Derebery, J., Campbell, U. B., Stang, P. E., Corrao, M. A., et al. (2008). The prevalence of nasal symptoms attributed to allergies in the United States: Findings from the burden of rhinitis in an America survey. Allergy and Asthma Proceedings, 29(6), 600–608.

NIH. (2013). Managing overweight and obesity in adults: Systematic evidence review from the obesity expert panel, 2013. https://www.nhlbi.nih.gov/sites/default/files/media/docs/obesity-evidence-review.pdf

Nur Husna, S. M., Tan, H.-T. T., Md Shukri, N., Mohd Ashari, N. S., & Wong, K. K. (2022). Allergic rhinitis: A clinical and pathophysiological overview. Frontiers in Medicine, 9.

Ober, C., & Yao, T. C. (2011). The genetics of asthma and allergic disease: A 21st century perspective. Immunological Reviews, 242(1), 10–30.

Pearce, N., Aït-Khaled, N., Beasley, R., Mallol, J., Keil, U., Mitchell, E., et al. (2007). Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax, 62(9), 758–766.

Reddel, H. K., FitzGerald, J. M., Bateman, E. D., Bacharier, L. B., Becker, A., Brusselle, G., et al. (2019). GINA 2019: A fundamental change in asthma management: Treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents. European Respiratory Journal, 53(6).

Savouré, M., Bousquet, J., Jaakkola, J. J. K., Jaakkola, M. S., Jacquemin, B., & Nadif, R. (2022). Worldwide prevalence of rhinitis in adults: A review of definitions and temporal evolution. Clinical and Translational Allergy, 12(3), e12130.

Small, P., Keith, P. K., & Kim, H. (2018). Allergic rhinitis. Allergy, Asthma & Clinical Immunology, 14(Suppl 2), 51.

Sorin, V., Klang, E., Sklair-Levy, M., Cohen, I., Zippel, D. B., Balint Lahat, N., et al. (2023). Large language model as a support tool for breast tumor board. npj Breast Cancer, 9(1).

Temsah, O., Khan, S. A., Chaiah, Y., Senjab, A., Alhasan, K., Jamal, A., et al. (2023). Overview of early ChatGPT’s presence in medical literature: Insights from a hybrid literature review by ChatGPT and human experts. Cureus.

Thenappan, A., Halaweish, I., Mody, R. J., Smith, E. A., Geiger, J. D., Ehrlich, P. F., et al. (2016). Review at a multidisciplinary tumor board impacts critical management decisions of pediatric patients with cancer. Pediatric Blood & Cancer, 64(2), 254–258.

Uprety, D., Zhu, D., & West, H. (2023). ChatGPT—A promising generative AI tool and its implications for cancer care. Cancer, 129(15), 2284–2289.

Vignola, A. M., Humbert, M., Bousquet, J., Boulet, L. P., Hedgecock, S., Blogg, M., et al. (2004). Efficacy and tolerability of anti-immunoglobulin E therapy with omalizumab in patients with concomitant allergic asthma and persistent allergic rhinitis: SOLAR. Allergy, 59(7), 709–717.

Walford, H. H., & Doherty, T. A. (2014). Diagnosis and management of eosinophilic asthma: A US perspective. Journal of Asthma and Allergy, 7, 53–65.

Wenzel, S. (2005). Severe asthma in adults. American Journal of Respiratory and Critical Care Medicine, 172(2), 149–160.

Zhou, N., Zhang, C. T., Lv, H. Y., Hao, C. X., Li, T. J., Zhu, J. J., et al. (2018). Concordance study between IBM Watson for Oncology and clinical practice for patients with cancer in China. The Oncologist, 24(6), 812–819.