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

Iseli, Thomas; Fischer, Galina Farina; Panje, Cédric; Glatzer, Markus; Hundsberger, Thomas; Rothermundt, Christian; Schmidt, Barbara; Sirén, Charlotta; Plasswilm, Ludwig; Putora, Paul Martin (2020). Insular Decision Criteria in Clinical Practice: Analysis of Decision-Making in Oncology. Oncology - international journal of cancer research and treatment, 98(6), pp. 438-444. Karger 10.1159/000508132

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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 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 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 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 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.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Panje, Cédric; Glatzer, Markus; Plasswilm, Ludwig and Putora, Paul Martin


600 Technology > 610 Medicine & health








Beatrice Scheidegger

Date Deposited:

08 Jun 2020 11:44

Last Modified:

06 Jul 2020 10:36

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Cancer Decision-making Insular criteria Oncology




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