Modeling In Medical Decision Making

Medical decision making has evolved in recent years, as more complex problems are being faced and addressed based on increasingly large amounts of data. In parallel, advances in computing power have led to a host of new and powerful statistical tools to support decision making. Simulation-based Bayesian methods are especially promising, as they provide a unified framework for data collection, inference, and decision making. In addition, these methods are simple to implement and can help to address the most pressing practical and ethical concerns arising in medical decision making. * Provides an overview of the necessary methodological background, including Bayesian inference, Monte Carlo simulation, and utility theory. * Driven by three real applications, presented as extensively detailed case studies. * Case studies include simplified versions of the analysis, to approach complex modelling in stages. * Features coverage of meta-analysis, decision analysis, and comprehensive decision modeling. * Accessible to readers with only a basic statistical knowledge. Primarily aimed at students and practitioners of biostatistics, the book will also appeal to those working in statistics, medical informatics, evidence-based medicine, health economics, health service research and health policy.

This cutting-edge volume is the first book that provides you with practical guidance on the use of medical device data for bioinformatics modeling purposes. You learn how to develop original methods for communicating with medical devices within healthcare enterprises and assisting with bedside clinical decision making. The book guides in the implementation and use of clinical decision support methods within the context of electronic health records in the hospital environment.This highly valuable reference also teaches budding biomedical engineers and bioinformaticists the practical benefits of using medical device data. Supported with over 100 illustrations, this all-in-one resource discusses key concepts in detail and then presents clear implementation examples to give you a complete understanding of how to use this knowledge in the field.

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.

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 financially constrained health systems across the world, increasing emphasis is being placed on the ability to demonstrate that health care interventions are not only effective, but also cost-effective. This book deals with decision modelling techniques that can be used to estimate the value for money of various interventions including medical devices, surgical procedures, diagnostic technologies, and pharmaceuticals. Particular emphasis is placed on the importance of the appropriate representation of uncertainty in the evaluative process and the implication this uncertainty has for decision making and the need for future research. This highly practical guide takes the reader through the key principles and approaches of modelling techniques. It begins with the basics of constructing different forms of the model, the population of the model with input parameter estimates, analysis of the results, and progression to the holistic view of models as a valuable tool for informing future research exercises. Case studies and exercises are supported with online templates and solutions. This book will help analysts understand the contribution of decision-analytic modelling to the evaluation of health care programmes. ABOUT THE SERIES: Economic evaluation of health interventions is a growing specialist field, and this series of practical handbooks will tackle, in-depth, topics superficially addressed in more general health economics books. Each volume will include illustrative material, case histories and worked examples to encourage the reader to apply the methods discussed, with supporting material provided online. This series is aimed at health economists in academia, the pharmaceutical industry and the health sector, those on advanced health economics courses, and health researchers in associated fields.

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

Health care systems are complex and, as a result, it is often unclear what the effects of changes in policy or service provision might be. At the same time, resources for health care tend to be in short supply, which means that public health practitioners have to make difficult decisions. This book describes the quantitative and qualitative methods that can help decision-makers to structure and clarify difficult problems and to explore the implications of pursuing different options. The accompanying CD ROM provides the opportunity to try out some of the proposed solutions. The book examines: Models and decision-making in health care Methods for clarifying complex decisions Models for service planning and resource allocation Modelling for evaluating changes in systems

This textbook offers a comprehensive analysis of medical decision making under uncertainty by combining Test Information Theory with Expected Utility Theory. 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 outcome is chosen by the decision maker. Moreover, 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 becomes endogenous. Finally, non-expected utility models of choice under risk and uncertainty (i.e. ambiguity) are presented. While these models can explain observed test and treatment decisions, they are not suitable for normative analyses aimed at providing guidance on medical decision making.