Insular Decision Criteria in Clinical Practice: Analysis of Decision-Making in Oncology.


Journal

Oncology
ISSN: 1423-0232
Titre abrégé: Oncology
Pays: Switzerland
ID NLM: 0135054

Informations de publication

Date de publication:
2020
Historique:
received: 29 11 2019
accepted: 24 04 2020
pubmed: 20 5 2020
medline: 27 6 2020
entrez: 20 5 2020
Statut: ppublish

Résumé

Medical decision-making is complex and involves a variety of decision criteria, many of which are universally recognised. However, decision-making analyses have demonstrated that certain decision criteria are not used uniformly among clinicians. We describe decision criteria, which for various contexts are only used by a minority of decision makers. For these, we introduce and define the term "insular criteria". 19 studies analysing clinical decision-making based on decision trees were included in our study. All studies were screened for decision-making criteria that were mentioned by less than three local decision makers in studies involving 8-26 participants. 14 out of the 19 included studies reported insular criteria. We identified 42 individual insular criteria. They could be intuitively allocated to seven major groups, these were: comorbidities, treatment, patients' characteristics/preferences, caretaker, scores, laboratory and tumour properties/staging. Insular criteria are commonly used in clinical decision-making, yet, the individual decision makers may not be aware of them. With this analysis, we demonstrate the existence of insular criteria and their variety. In daily practice and clinical studies, awareness of insular criteria is important.

Sections du résumé

BACKGROUND BACKGROUND
Medical decision-making is complex and involves a variety of decision criteria, many of which are universally recognised. However, decision-making analyses have demonstrated that certain decision criteria are not used uniformly among clinicians.
AIM OBJECTIVE
We describe decision criteria, which for various contexts are only used by a minority of decision makers. For these, we introduce and define the term "insular criteria".
METHODS METHODS
19 studies analysing clinical decision-making based on decision trees were included in our study. All studies were screened for decision-making criteria that were mentioned by less than three local decision makers in studies involving 8-26 participants.
RESULTS RESULTS
14 out of the 19 included studies reported insular criteria. We identified 42 individual insular criteria. They could be intuitively allocated to seven major groups, these were: comorbidities, treatment, patients' characteristics/preferences, caretaker, scores, laboratory and tumour properties/staging.
CONCLUSION CONCLUSIONS
Insular criteria are commonly used in clinical decision-making, yet, the individual decision makers may not be aware of them. With this analysis, we demonstrate the existence of insular criteria and their variety. In daily practice and clinical studies, awareness of insular criteria is important.

Identifiants

pubmed: 32428914
pii: 000508132
doi: 10.1159/000508132
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

438-444

Informations de copyright

© 2020 S. Karger AG, Basel.

Auteurs

Thomas Iseli (T)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland, thomas.iseli@kssg.ch.

Galina Farina Fischer (GF)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Cédric Michael Panje (CM)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Markus Glatzer (M)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Thomas Hundsberger (T)

Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Department of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Christian Rothermundt (C)

Department of Haematology and Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Barbara Schmidt (B)

University of St. Gallen, St. Gallen, Switzerland.

Charlotta Sirén (C)

University of Queensland, Brisbane, Queensland, Australia.

Ludwig Plasswilm (L)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
University of Bern, Bern, Switzerland.

Paul Martin Putora (PM)

Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
University of Bern, Bern, Switzerland.

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