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Objective consensus from decision trees

BACKGROUND: Consensus-based approaches provide an alternative to evidence-based decision making, especially in situations where high-level evidence is limited. Our aim was to demonstrate a novel source of information, objective consensus based on recommendations in decision tree format from multiple...

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Autores principales: Putora, Paul Martin, Panje, Cedric M, Papachristofilou, Alexandros, Pra, Alan Dal, Hundsberger, Thomas, Plasswilm, Ludwig
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269842/
https://www.ncbi.nlm.nih.gov/pubmed/25476988
http://dx.doi.org/10.1186/s13014-014-0270-y
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author Putora, Paul Martin
Panje, Cedric M
Papachristofilou, Alexandros
Pra, Alan Dal
Hundsberger, Thomas
Plasswilm, Ludwig
author_facet Putora, Paul Martin
Panje, Cedric M
Papachristofilou, Alexandros
Pra, Alan Dal
Hundsberger, Thomas
Plasswilm, Ludwig
author_sort Putora, Paul Martin
collection PubMed
description BACKGROUND: Consensus-based approaches provide an alternative to evidence-based decision making, especially in situations where high-level evidence is limited. Our aim was to demonstrate a novel source of information, objective consensus based on recommendations in decision tree format from multiple sources. METHODS: Based on nine sample recommendations in decision tree format a representative analysis was performed. The most common (mode) recommendations for each eventuality (each permutation of parameters) were determined. The same procedure was applied to real clinical recommendations for primary radiotherapy for prostate cancer. Data was collected from 16 radiation oncology centres, converted into decision tree format and analyzed in order to determine the objective consensus. RESULTS: Based on information from multiple sources in decision tree format, treatment recommendations can be assessed for every parameter combination. An objective consensus can be determined by means of mode recommendations without compromise or confrontation among the parties. In the clinical example involving prostate cancer therapy, three parameters were used with two cut-off values each (Gleason score, PSA, T-stage) resulting in a total of 27 possible combinations per decision tree. Despite significant variations among the recommendations, a mode recommendation could be found for specific combinations of parameters. CONCLUSION: Recommendations represented as decision trees can serve as a basis for objective consensus among multiple parties.
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spelling pubmed-42698422014-12-18 Objective consensus from decision trees Putora, Paul Martin Panje, Cedric M Papachristofilou, Alexandros Pra, Alan Dal Hundsberger, Thomas Plasswilm, Ludwig Radiat Oncol Methodology BACKGROUND: Consensus-based approaches provide an alternative to evidence-based decision making, especially in situations where high-level evidence is limited. Our aim was to demonstrate a novel source of information, objective consensus based on recommendations in decision tree format from multiple sources. METHODS: Based on nine sample recommendations in decision tree format a representative analysis was performed. The most common (mode) recommendations for each eventuality (each permutation of parameters) were determined. The same procedure was applied to real clinical recommendations for primary radiotherapy for prostate cancer. Data was collected from 16 radiation oncology centres, converted into decision tree format and analyzed in order to determine the objective consensus. RESULTS: Based on information from multiple sources in decision tree format, treatment recommendations can be assessed for every parameter combination. An objective consensus can be determined by means of mode recommendations without compromise or confrontation among the parties. In the clinical example involving prostate cancer therapy, three parameters were used with two cut-off values each (Gleason score, PSA, T-stage) resulting in a total of 27 possible combinations per decision tree. Despite significant variations among the recommendations, a mode recommendation could be found for specific combinations of parameters. CONCLUSION: Recommendations represented as decision trees can serve as a basis for objective consensus among multiple parties. BioMed Central 2014-12-05 /pmc/articles/PMC4269842/ /pubmed/25476988 http://dx.doi.org/10.1186/s13014-014-0270-y Text en © Putora et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Methodology
Putora, Paul Martin
Panje, Cedric M
Papachristofilou, Alexandros
Pra, Alan Dal
Hundsberger, Thomas
Plasswilm, Ludwig
Objective consensus from decision trees
title Objective consensus from decision trees
title_full Objective consensus from decision trees
title_fullStr Objective consensus from decision trees
title_full_unstemmed Objective consensus from decision trees
title_short Objective consensus from decision trees
title_sort objective consensus from decision trees
topic Methodology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269842/
https://www.ncbi.nlm.nih.gov/pubmed/25476988
http://dx.doi.org/10.1186/s13014-014-0270-y
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