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This volume presents novel concepts to help physicians and health care providers better understand the thought processes and approaches used in clinical decision-making and how we develop those skills as we transition from being a medical student to post-graduate trainee to independent practitioner. Approaches presented range from simple rules of thumb, pattern recognition, and heuristics, to more formulaic methods such as standard operating procedures, checklists, evidence-based medicine, mathematical modeling, and statistics. Ways to recognize and manage errors and how our decision-making can be improved, are also discussed. An Introduction to Medical Decision-Making presents several innovative techniques to allow the reader to use the principles presented and integrate the ethical, humanistic and social aspects of decision-making with the pragmatic and knowledge-based aspects of clinical medicine. It also highlights how our thinking processes, emotions, and biases affect decision-making. This invaluable resource will allow students and physicians to evaluate and critically discuss their decisions objectively to become more efficient and effective, and maximize the quality of care they provide.
Medical Decision Making provides clinicians with a powerful framework for helping patients make decisions that increase the likelihood that they will have the outcomes that are most consistent with their preferences. This new edition provides a thorough understanding of the key decision making infrastructure of clinical practice and explains the principles of medical decision making both for individual patients and the wider health care arena. It shows how to make the best clinical decisions based on the available evidence and how to use clinical guidelines and decision support systems in electronic medical records to shape practice guidelines and policies. Medical Decision Making is a valuable resource for all experienced and learning clinicians who wish to fully understand and apply decision modelling, enhance their practice and improve patient outcomes. “There is little doubt that in the future many clinical analyses will be based on the methods described in Medical Decision Making, and the book provides a basis for a critical appraisal of such policies.” - Jerome P. Kassirer M.D., Distinguished Professor, Tufts University School of Medicine, US and Visiting Professor, Stanford Medical School, US
The Encyclopedia of Medical Decision Making presents state-of-the-art research and ready-to-use facts sorting out findings on medical decision making and their applications.
A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.
Decision Making in Health Care, first published in 2000, is a comprehensive overview of the field of medical decision making.
Computer technology has impacted the practice of medicine in dramatic ways. Imaging techniques provide noninvasive tools which alter the diag nostic process. Sophisticated monitoring equipment presents new levels of detail for both patient management and research. In most of these high technology applications, the computer is embedded in the device; its presence is transparent to the user. There is also a growing number of applications in which the health care provider directly interacts with a computer. In many cases, these appli cations are limited to administrative functions, e.g., office practice man agement, location of hospital patients, appointments, and scheduling. Nevertheless, there also are instances of patient care functions such as results reporting, decision support, surveillance, and reminders. This series, Computers and Medicine, will focus upon the direct use of information systems as it relates to the medical community. After twenty-five years of experimentation and experience, there are many tested applications which can be implemented economically using the current generation of computers. Moreover, the falling cost of computers suggests that there will be even more extensive use in the near future. Yet there is a gap between current practice and the state-of-the-art.
Describes Bayesian inference, Monte Carlo simulation, utility theory and gives case studies of their use.
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.
For the past few years, the author, a renowned economist, has been applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. He shows how statistical imprecision and identification problems affect empirical research in the patient-care sphere.
The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.