Exploratory Analysis of Dunning–Kruger Effect Among Oncologists Managing Prostatic Adenocarcinoma Candidates for Radionuclide Therapy

Background/Aim: The study aimed to analyze the Dunning-Kruger effect (DKE) in oncologists’ self-perceived and accurate knowledge of scientific data, prescribing indications, and clinical results of the new radioligand therapy (RLT) for metastatic castration-resistant prostate carcinoma (mCRPC). Patients and Methods: Clinical oncologists, including urologists, medical and radiation oncologists, were asked to voluntarily participate in a web-based nine-question test to explore the DKE in the clinical setting of 177-lutetium RLT for mCRPC. Before the test, participants were asked to estimate their performance percentage on a scale from 1 (poor performance, lack of knowledge) to 100 (efficient, entirely accurate performance, expert). A board of six experts evaluated knowledge performance, reporting results as a percentage on a 0-100% scale. Results: A total of 128 physicians agreed to participate and completed the questionnaire. Participants were divided into four quartile groups based on their ranked test scores. The observed difference between self-estimation and actual knowledge performance was statistically significant, indicating that less skilled participants often overestimate their abilities. Specialty, work environment, scientific production, participation in a multidisciplinary board, and expertise were all strongly correlated with quartile level (p<0.001). Conclusion: Clinical oncologists display significant DKE when assessed in the developing therapeutic area of RLT in mCRPC. These results underscore the need to transition toward multidisciplinary training programs, which are essential for effective education in RLT.