Modeling the Decisions Regarding Oncological Practice Under Uncertainty Conditions

Abstract

BACKGROUND: The existence of multiple decision criteria is due to a variety of cancer types, health systems, treatments, options and individual factors, a multitude of different criteria that can be considered in the routine clinical decision in oncology.
THE METHOD USED: The decision under conditions of uncertainty corresponds to the case where the probabilities of achieving the states of the objective factors are not known, which can be not only natural factors (medical, related to the patient's state of health), but also economic, social, political factors (government cancer policy, law enforcement, treatment regulation, risk groups, interest groups, etc.), to the extent that they are not controllable by the decision maker. Among the analysis models under conditions of uncertainty, the Weighted Optimism Criterion (Hurwicz) was chosen, based on which a coefficient is defined that shows how optimistic or pessimistic the decision-maker is.
RESULTS: The model allows a sensitivity analysis of the solution by the changing of the value of the optimism index, which makes the analysis of decisions under conditions of uncertainty applicable to a large number of patients from different socio-economic backgrounds and with different temperaments (which can be influenced by age and/or gender). The optimistic patient is more concerned with Treatment Compliance, i.e. long-term survival, and the pessimistic patient is also majorly concerned with Treatment Compliance, but he/she also becomes concerned with ”treatment toxicity”, so short-term effects. Regardless of the degree of optimism, the second place in the patient's concern is the institution's performance and the doctor's experience, which thus become determining factors - directly related to the level of trust, regardless of the type of patient.
CONCLUSIONS: The analysis of the way of making decisions under conditions of uncertainty is relevant for the strategy of approaching the decision made through the doctor-patient agreement.