Diagnostic Decision Making in Oncology: Creating Shared Knowledge and Managing Complexity

Authors: Francesca Alby, Cristina Zucchermaglio & Mattia Baruzzo

Drawing upon the concept of practice, the article explores diagnostic decision making in oncology through the analysis of informal conversations between doctors in an Italian hospital. The analysis shows that doctors rely on three collaborative practices: (a) joint interpretation, (b) intersubjective generation and validation of hypotheses, and (c) postponing the diagnostic decision. Through such practices, doctors jointly handle tough issues such as managing complexity, dealing with cognitive difficulties and limits of knowledge, and avoiding diagnostic errors. The article addresses some lacunae in the literature by providing empirical access to how decision making is done in an understudied and specialized branch of medicine.