Decision Support Systems in Gastrointestinal Oncology

Abstract

In ancient times a medix was not a doctor at all, but a judge, a magistrate of Osci (ancient Italian people); in ancient Greek µεδω had meant to manage, to take care of someone, to produce rules, to make decisions, and to arbitrate between possible alternatives. Nowadays the medical person, a physician, is a decision maker as regards quod vitam and quod valitudinem (quality and expectancy of life). The hallmark of a good physician is his ability to make sound clinical judgments. Traditionally this has been considered an artful and intuitive process, neither subject to theoretical analysis nor to be captured in a formal quantitative model [5]. Elstein et al. [19] described four major components of the reasoning process with deductive method: cue acquisition, which includes the acquisition of a history, performance of a physical examination, and a request for diagnostic procedures; hypothesis generation, in which alternative hypotheses are retrived from the physician’s memory; cue interpretation, in which the data are considered in view of their contribution to alternative hypotheses; and hypothesis evaluation, in which the data are weighted and combined to determine which hypotheses are confirmed or rejected. The final step, the decision, depends on the clinical environment; it is related to social, economic, demographic, cultural, and organizing contexts.