Decision Making in Medicine

DECISION MAKING IN MEDICINE offers an algorithmic approach to the diagnosis and treatment of common disorders and diseases. by providing nearly 250 clinical decision making algorithms, this practical reference helps you arrive at the proper diagnosis and also leads you to the appropriate therapy or course of action. Brief text appears on the page facing each algorithm to provide additional explanations or details about key decision points on the algorithm. Topics are organized by sign, symptom, problem, or laboratory abnormality. the consistent format and decision tree approach of DECISION MAK

A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.

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.

This textbook offers a comprehensive theory of medical decision making under uncertainty, combining informative test theory with the expected utility hypothesis. The book shows how the parameters of Bayes’ theorem can be combined with a value function of health states to arrive at informed test and treatment decisions. The authors distinguish between risk neutral, risk averse and prudent decision makers and demonstrate the effects of risk preferences on physicians’ decisions. They analyze individual tests, multiple tests and endogenous tests where the test result is determined by the decision maker. Finally, the topic is examined in the context of health economics by introducing a trade-off between enjoying health and consuming other goods, so that the extent of treatment and thus the potential improvement in the patient’s health become endogenous.

Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the research and theory from the science of decision making into clinically useful tools and principles that can be applied by clinicians in the field. It considers issues of patient goals, uncertainty, judgement, choice, development of new information, and family and social concerns in healthcare. It helps to demystify decision theory by emphasizing concepts and clinical cases over mathematics and computation.

Decision making is a critical element in the field of medicine that can lead to life-or-death outcomes, yet it is an element fraught with complex and conflicting variables, diagnostic and therapeutic uncertainties, patient preferences and values, and costs. Together, decisions made by physicians, patients, insurers, and policymakers determine the quality of health care, quality that depends inherently on counterbalancing risks and benefits and competing objectives such as maximizing life expectancy versus optimizing quality of life or quality of care versus economic realities. Broadly speaking, concepts in medical decision making (MDM) may be divided into two major categories: prescriptive and descriptive. Work in the area of prescriptive MDM investigates how medical decisions should be done using complicated analyses and algorithms to determine cost-effectiveness measures, prediction methods, and so on. In contrast, descriptive MDM studies how decisions actually are made involving human judgment, biases, social influences, patient factors, and so on. The Encyclopedia of Medical Decision Making gives a gentle introduction to both categories, revealing how medical and healthcare decisions are actually made—and constrained—and how physician, healthcare management, and patient decision making can be improved to optimize health outcomes. Key Features Discusses very general issues that span many aspects of MDM, including bioethics; health policy and economics; disaster simulation modeling; medical informatics; the psychology of decision making; shared and team medical decision making; social, moral, and religious factors; end-of-life decision making; assessing patient preference and patient adherence; and more Incorporates both quantity and quality of life in optimizing a medical decision Considers characteristics of the decisionmaker and how those characteristics influence their decisions Presents outcome measures to judge the quality or impact of a medical decision Examines some of the more commonly encountered biostatistical methods used in prescriptive decision making Provides utility assessment techniques that facilitate quantitative medical decision making Addresses the many different assumption perspectives the decision maker might choose from when trying to optimize a decision Offers mechanisms for defining MDM algorithms With comprehensive and authoritative coverage by experts in the fields of medicine, decision science and cognitive psychology, and healthcare management, this two-volume Encyclopedia is a must-have resource for any academic library.

DECISION MAKING IN MEDICINE offers an algorithmic approach to the diagnosis and treatment of common disorders and diseases. By providing nearly 250 clinical decision making algorithms, this practical reference helps you arrive at the proper diagnosis and also leads you to the appropriate therapy or course of action. Brief text appears on the page facing each algorithm to provide additional explanations or details about key decision points on the algorithm. Topics are organized by sign, symptom, problem, or laboratory abnormality. The consistent format and decision tree approach of DECISION MAKING IN MEDICINE is certain to enhance your clinical efficiency. Algorithmic format promotes systematic thinking and logical clinical decision making Comprehensive coverage includes general medicine, internal medicine, women's health, emergency medicine, urology, behavioral medicine and pharmacology Brief text accompanies each algorithm to explain and highlight key steps of the decision making process New section on Women's Health presents conditions that affect women NEW TO THIS EDITION Gives greater emphasis to conditions unique to women in a new section on women's health Spanish version of 1st edition also available, ISBN: 84-8174-103-5

This analysis of the law's approach to healthcare decision-making critiques its liberal foundations in respect of three categories of people: adults with capacity, adults without capacity and adults who are subject to mental health legislation. Focusing primarily on the law in England and Wales, the analysis also draws on the law in the United States, legal positions in Australia, Canada, Ireland, New Zealand and Scotland and on the human rights protections provided by the ECHR and the Convention on the Rights of Persons with Disabilities. Having identified the limitations of a legal view of autonomy as primarily a principle of non-interference, Mary Donnelly questions the effectiveness of capacity as a gatekeeper for the right of autonomy and advocates both an increased role for human rights in developing the conceptual basis for the law and the grounding of future legal developments in a close empirical interrogation of the law in practice.

Clinical Decision Making in Complementary and amp; Alternative Medicine differs from other medical texts by introducing a systematic clinical framework for the practice of complementary and alternative medicine. While comparable titles may explore the use or efficacy of specific complementary and alternative medicine interventions, this indispensible textbook highlights evidence-based interventions, while helping practitioners apply them within a clinical decision making framework. Clinical Decision Making in Complementary and amp; Alternative Medicine is a one-of-a-kind health reference for clinicians, stu

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.

In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish interventions that are both effective and cost-effective. Usually a single study will not fully address these issues and it is desirable to synthesize evidence from multiple sources. This book aims to provide a practical guide to evidence synthesis for the purpose of decision making, starting with a simple single parameter model, where all studies estimate the same quantity (pairwise meta-analysis) and progressing to more complex multi-parameter structures (including meta-regression, mixed treatment comparisons, Markov models of disease progression, and epidemiology models). A comprehensive, coherent framework is adopted and estimated using Bayesian methods. Key features: A coherent approach to evidence synthesis from multiple sources. Focus is given to Bayesian methods for evidence synthesis that can be integrated within cost-effectiveness analyses in a probabilistic framework using Markov Chain Monte Carlo simulation. Provides methods to statistically combine evidence from a range of evidence structures. Emphasizes the importance of model critique and checking for evidence consistency. Presents numerous worked examples, exercises and solutions drawn from a variety of medical disciplines throughout the book. WinBUGS code is provided for all examples. Evidence Synthesis for Decision Making in Healthcare is intended for health economists, decision modelers, statisticians and others involved in evidence synthesis, health technology assessment, and economic evaluation of health technologies.

Tells doctors and students how to evaluate complex clinical information to improve health care.

This work translates the major principles of medical decision making into clinically revelant and easy to understand terms. It aims to help the reader feel confident about giving the best advice in the face of inherent uncertainties of real-world medicine.

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability.

"A CRC title, part of the Taylor & Francis imprint, a member of the Taylor & Francis Group, the academic division of T&F Informa plc."

This book clearly demonstrates how to best make medicaldecisions while incorporating clinical practice guidelines anddecision support systems for electronic medical record systems. New to this edition is how medical decision making ideas arebeing incorporated into clinical decision support systems inelectronic medical records and also how they are being used toshape practice guidelines and policies.

Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. Evidence-Based Emergency Medicine, a highly readable primer, will be the first book to teach EBM principles and their clinical application with the unique mindset and needs of the Emergency Medicine physician in mind This one-of-a-kind guide discusses the search, evaluation, and proper use of the literature of emergency medicine, from textbooks to trials and qualitative studies to systematic reviews. It reveals how and where to find the quality information needed when seconds count. Fully exploring medical decision making using cognitive psychology, Bayesian analysis and more, it shows how to apply the knowledge they provide to achieve superior diagnosis and management of ED patients. The avoidance of medical errors is emphasized through the precepts of critical thinking and heuristics.

This book offers an overview of the main questions arising when biomedical decision-making intersects ethical decision-making. It reports on two ethical decision-making methodologies, one addressing the patients, the other physicians. It shows how patients’ autonomous choices can be empowered by increasing awareness of ethical deliberation, and at the same time it supports healthcare professionals in developing an ethical sensitivity, which they can apply in their daily practice. The book highlights the importance and relevance of practicing bioethics in the age of personalized medicine. It presents concrete cases studies dealing with cancer and genetic diseases, where difficult decisions need to be made by all the parties involved: patients, physicians and families. Decisions concern not only diagnostic procedures and treatments, but also moral values, religious beliefs and ways of seeing life and death, thus adding further layers of complexity to biomedical decision-making. This book, which is strongly rooted in the philosophical tradition, features non-directive counseling and patient-centeredness. It provides a concise yet comprehensive and practice-oriented guide to decision-making in modern healthcare.