Risk And Medical Decision Making

For people interested in risk management, medical activity represents a stimulating field of study and thought. On the one hand, progress in medical knowledge and technology tends to reduce the risks to survival that individuals would face in the absence of appropriate diagnostic or therapeutic instruments. On the other hand, new medical technologies simultaneously create their own specific risks, sometimes simply because their effects are less well-known than those of established ones. In a sense any medical progress simultaneously generates new risks while destroying old ones. Moreover, unlike many financial risks that can be either divided or transferred to others (e.g. through diversification, insurance or social security) the personal aspects of medical risks are by essence indivisible and non-transferable. As a result, they are in a sense more threatening than financial risks for risk averse patients. These two facts explain and justify the growing interest in risk economics for the fields of medical decision making and health economics. In Risk and Medical Decision Making, part 1 is developed inside the expected utility (E-U) model and analyses how comorbidity risks affect the well-known "test-treatment" thresholds. Part 2 is devoted to a specific non E-U model with the same purpose: how would one define a threshold in this context and how would one value a diagnostic test? In each of these two parts both diagnostic and therapeutic risks are considered.

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This textbook offers a comprehensive analysis of medical decision-making under uncertainty by combining test information theory with expected utility theory. The authors show how the parameters of Bayes’ theorem can be combined with a value function of health states in order to arrive at informed test and treatment decisions in the face of diagnostic and therapeutic risks. Distinguishing between risk-neutral, risk-averse, and prudent decision-makers, they demonstrate the effects of risk preferences on medical decisions. Furthermore, they analyze individual and multiple tests as well as diagnostic models in which the decision-maker chooses the test outcome. The consequences of test and treatment decisions for the patient are encompassed by quality-adjusted life years (QALYs) and the standard economic model, which applies the willingness to pay for health approach. Lastly, non-expected utility models of choice under risk and uncertainty are presented. Although these models can explain some of the test and treatment decisions observed, they are less suitable for normative analyses aimed at providing guidance on medical decision-making. This third edition provides extensively revised versions of all chapters and reflects recent innovations in medical decision-making such as decision curve analysis. New chapters focus on the health economics of and revealed preferences in medical decisions. The book is intended for students of (health) economics and medicine as well as for medical decision-makers and physicians dealing with uncertainty in their test and treatment decisions.

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

Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.

Never before have the powerful techniques of decision analysis had more importance for patient and doctor. This book translates the major principles of medical decision making into clinically relevant and easy-to-understand terms. Filled with examples drawn from patient care and familiar games of chance, Making Medical Decisions teaches the reader how to feel confident about giving the best advice in the face of the inherent uncertainties of real-world medicine.

MEDICAL DECISION MAKING Detailed resource showing how to best make medical decisions while incorporating clinical practice guidelines and decision support systems Sir William Osler, a legendary physician of an earlier era, once said, “Medicine is a science of uncertainty and an art of probability.” In Osler’s day, and now, decisions about treatment often cannot wait until the diagnosis is certain. Medical Decision Making is about how to make the best possible decision given that uncertainty. The book shows how to tailor decisions under uncertainty to achieve the best outcome based on published evidence, features of a patient’s illness, and the patient’s preferences. Medical Decision Making describes a powerful framework for helping clinicians and their patients reach decisions that lead to outcomes that the patient prefers. That framework contains the key principles of patient-centered decision-making in clinical practice. Since the first edition of Medical Decision Making in 1988, the authors have focused on explaining key concepts and illustrating them with clinical examples. For the Third Edition, every chapter has been revised and updated. Written by four distinguished and highly qualified authors, Medical Decision Making includes information on: How to consider the possible causes of a patient’s illness and decide on the probability of the most important diagnoses. How to measure the accuracy of a diagnostic test. How to help patients express their concerns about the risks that they face and how an illness may affect their lives. How to describe uncertainty about how an illness may change over time. How to construct and analyze decision trees. How to identify the threshold for doing a test or starting treatment How to apply these concepts to the design of practice guidelines and medical policy making. Medical Decision Making is a valuable resource for clinicians, medical trainees, and students of decision analysis who wish to fully understand and apply the principles of decision making to clinical practice.