Creation of clinical algorithms for decision-making in oncology: an example with dose prescription in radiation oncology.

Dennstädt, Fabio; Treffers, Theresa; Iseli, Thomas; Panje, Cédric; Putora, Paul Martin (2021). Creation of clinical algorithms for decision-making in oncology: an example with dose prescription in radiation oncology. BMC medical informatics and decision making, 21(1), p. 212. BioMed Central 10.1186/s12911-021-01568-w

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In oncology, decision-making in individual situations is often very complex. To deal with such complexity, people tend to reduce it by relying on their initial intuition. The downside of this intuitive, subjective way of decision-making is that it is prone to cognitive and emotional biases such as overestimating the quality of its judgements or being influenced by one's current mood. Hence, clinical predictions based on intuition often turn out to be wrong and to be outperformed by statistical predictions. Structuring and objectivizing oncological decision-making may thus overcome some of these issues and have advantages such as avoidance of unwarranted clinical practice variance or error-prevention. Even for uncertain situations with limited medical evidence available or controversies about the best treatment option, structured decision-making approaches like clinical algorithms could outperform intuitive decision-making. However, the idea of such algorithms is not to prescribe the clinician which decision to make nor to abolish medical judgement, but to support physicians in making decisions in a systematic and structured manner. An example for a use-case scenario where such an approach may be feasible is the selection of treatment dose in radiation oncology. In this paper, we will describe how a clinical algorithm for selection of a fractionation scheme for palliative irradiation of bone metastases can be created. We explain which steps in the creation process of a clinical algorithm for supporting decision-making need to be  performed and which challenges and limitations have to be considered.

Item Type:

Journal Article (Review Article)

Division/Institute:

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

UniBE Contributor:

Panje, Cédric and Putora, Paul Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1472-6947

Publisher:

BioMed Central

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

03 Dec 2021 17:51

Last Modified:

05 Dec 2021 01:45

Publisher DOI:

10.1186/s12911-021-01568-w

PubMed ID:

34247596

Uncontrolled Keywords:

Bone metastases Clinical algorithm Decision strategy Decision-making Dose prescription Radiation oncology

BORIS DOI:

10.48350/161273

URI:

https://boris.unibe.ch/id/eprint/161273

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