Decision Making Criteria in Oncology

Abstract

Decision making is one of the most complex skills required of an oncologist and is affected by a broad range of parameters. For example, the wide variety of treatment options, with various outcomes, side-effects and costs present challenges in selecting the most appropriate treatment. Many treatment choices are affected by limited scientific evidence, availability of therapies or patient-specific factors. In the decision making process, standardized approaches can be useful, but a multitude of criteria are relevant to this process. Thus, the aim of this review is to summarize common types of decision criteria used in oncology by focusing on 3 main categories: criteria associated with the decision maker (both patient and doctor), decision specific criteria, and the often-overlooked contextual factors. Our review aims to highlight the broad range of decision criteria in use, as well as variations in their interpretation.

Emotions as Social Information in Shared Decision-Making in Oncology

“…For example, multiple drugs, often from different pharmaceutical companies, can be available for the same disease or similar outcomes can be achieved with very different modalities (e.g., surgery or radiotherapy [14,15]). In oncology, many decisions can be considered highstakes and a variety of decision criteria can be called upon to make a recommendation on the physician's side and a decision on the patient's side [16]. Hence, oncological decision-making is complex and requires substantive processing which gives rise to emotional, and thus potentially biasing, influences.…”

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

“…Unlike the classical concept of the homo oeconomicus, medical decision-making deals with far more non-rational modes of thinking (including "intuition" or "emotions"), diagnostic or therapeutic uncertainties and insufficient data for specific situations [18][19][20]. To get a better overview of the complexities and variability of decision-making criteria in oncology, Glatzer et al [6] reflected on the adaptation of classical managerial decision-making into the field of oncology, adhering to the three categories "decision maker-related", "decision-specific" and "contextual" factors. Our findings show similar characteristics and fit into these categories (see Table 2).…”

“…This view is dominated by the idea, that decision makers evaluate options by comparing them to previous situations and choose the one with the highest compatibility by applying intuition and patternmatching mechanisms [4]. Medical decision-making is to choose among a multitude of treatment options, based on various explicit and implicit decision criteria [5,6]. Among Oncology 2020;98:438-444 DOI: 10.1159/000508132 other factors, decision-making is dependent on knowledge, which may be limited in a specific domain.…”

Long‐term oncological and functional follow‐up in low‐dose‐rate brachytherapy for prostate cancer: results from the prospective nationwide Swiss registry

“…For intermediate‐ and high‐risk carcinomas, the therapy is associated with an increased risk of recurrence, but based on our experience and data; it may offer a treatment option in selected cases. If multiple treatment options are present, patient preference is often not only dictated by oncological outcomes, but by a multitude of factors including functional results .…”