Decision committees in oncology: from standard to actual cases

Bulletin du Cancer. Volume 86, Number 9, 767-72, Septembre 1999, Articles originaux

Author(s) : Catherine Sauvagnac, Véronique Beckendorf, Anne Lesur, Elizabeth Luporsi, Joseph Stines, Pierre Falzon, Pierre Bey, Laboratoire d’ergonomie du CNAM, 41, rue Gay-Lussac, 75005 Paris..

Summary : Medical decision making, especially in oncology, is more and more assisted by pre-established therapeutic protocols. But applying these protocols for particular cases is sometimes difficult ; then, local expertise intervenes. For solving these difficult cases, Alexis-Vautrin like other centers, organizes committees for therapeutic decisions. This paper aims to describe, from a field study, the tools for medical decision making and the difficulties of using them. These result of the analysis of decision committee for breast cancers in a center using of protocols, which the firts were established twenty years ago. This analysis was carried out by a team of oncologists and ergonomists ; it stresses on collective decision making as a mean for adapting rules and exchanging knowledge. Furthermore, these findings lead to discuss using of decision committee for advancement and particularization of protocols themselves.

Keywords : collective decision-making, therapeutic rules, rules development.

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