Decision Making In Health Care

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.

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.

First edition published as: Evidence-based patient choice.. Oxford: Oxford University Press, 2001.

An evidence-based analysis of the opportunities and challenges of moving towards more person-centred health systems.

This comprehensive reference delves into the complex process of medical decision making—both the nuts-and-bolts access and insurance issues that guide choices and the cognitive and affective factors that can make patients decide against their best interests. Wide-ranging coverage offers a robust evidence base for understanding decision making across the lifespan, among family members, in the context of evolving healthcare systems, and in the face of life-changing diagnosis. The section on applied decision making reviews the effectiveness of decision-making tools in healthcare, featuring real-world examples and guidelines for tailored communications with patients. Throughout, contributors spotlight the practical importance of the field and the pressing need to strengthen health decision-making skills on both sides of the clinician/client dyad. Among the Handbook’s topics: From laboratory to clinic and back: connecting neuroeconomic and clinical mea sures of decision-making dysfunctions. Strategies to promote the maintenance of behavior change: moving from theoretical principles to practices. Shared decision making and the patient-provider relationship. Overcoming the many pitfalls of communicating risk. Evidence-based medicine and decision-making policy. The internet, social media, and health decision making. The Handbook of Health Decision Science will interest a wide span of professionals, among them health and clinical psychologists, behavioral researchers, health policymakers, and sociologists.

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

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.