title: [Decision process in a multidisciplinary cancer team with limited evidence].
abstract: BACKGROUND
  The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome.
  
  
  METHODS
  To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15).
  
  
  RESULTS
  The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board.
  
  
  CONCLUSIONS
  With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process.
authors: Arbeits-, Ingenieur- und Organisationspsychologie, Institut für Psychologie und Arbeitswissenschaft, Technische Universität Berlin, Berlin.
authors: R
authors: R
authors: Lassalle
authors: Arbeits-, Ingenieur- und Organisationspsychologie, Institut für Psychologie und Arbeitswissenschaft, Technische Universität Berlin, Berlin.
authors: J
authors: J
authors: Marold
authors: Fakultät für Psychologie, Universität Basel, Basel, Switzerland.
authors: M
authors: M
authors: Schöbel
authors: Lehrstuhl Arbeits- und Organisationspsychologie, Psychologie und Ergonomie, Berlin.
authors: D
authors: D
authors: Manzey
authors: Innovation Center Computer Assisted Surgery (ICCAS), Leipzig.
authors: S
authors: S
authors: Bohn
authors: Innovation Center Computer Assisted Surgery (ICCAS), Leipzig.
authors: A
authors: A
authors: Dietz
authors: Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Opera-tionen, Universität Leipzig, Leipzig.
authors: A
authors: A
authors: Boehm
mesh_terms: D002983:Clinical Competence; D032921:Consensus; D003299:Cooperative Behavior; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006801:Humans; D033183:Interdisciplinary Communication; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D061214:Patient Safety; D011795:Surveys and Questionnaires; D035501:Uncertainty; D014741:Video Recording