Threshold Decision Making In Clinical Medicine

This book aims to provide threshold models to help physicians to make optimal diagnostic, therapeutic and predictive decisions. Readers will not only find theoretical information but also practical examples illustrating how these decisions should be made. Poor decision-making is considered a leading cause of death in contemporary medicine. Decisions, however, have to be made - at a given threshold of risk and unfortunately physicians are not trained on how to make decisions. This book provides help to all those who want to improve their decision-making for a better patient outcome. With its examples from hematology and oncology the book will not only benefit haematologists and oncologists but physicians from all disciplines, hence the threshold model is applicable to all fields in medicine. This book will be useful to experienced physicians as well as trainees alike.

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.

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 timely collection brings together philosophical, legal and sociological perspectives on the crucial question of who should make decisions about the fate of a child suffering from a serious illness. In particular, the collection looks at whether the current 'best interests' threshold is the appropriate boundary for legal intervention, or whether it would be more appropriate to adopt the 'risk of significant harm' approach proposed in Gard. It explores the roles of parents, doctors and the courts in making decisions on behalf of children, actively drawing on perspectives from the clinic as well as academia and practice. In doing so, it teases out the potential risks of inappropriate state intrusion in parental decision-making, and considers how we might address them.

Since it was first published in 1988, ""Medical Decision Making"" has become the world-wide standard textbook for medical decision making. Written to meet the needs of medical students and experienced clinicians alike, this book is a clearly presented, step-by-step guide to understanding how, through the processes of decision analysis, a physician can reach valid, reasoned conclusions about medical treatment despite imperfect information about the patient. The focus of ""Medical Decision Making"" is on estimating probability, measuring the inaccuracy of clinical data, and interpreting new information, then making choices: should the patient be treated, should more information be obtained, or should nothing be done? The authors make extensive use of clinical examples to illustrate Bayesian analysis, formal decision analysis, and basic concepts of how to evaluate the usefulness of diagnostic tests in various situations. The text is supplemented with many illustrations, useful end-of-chapter self-assessment questions, an appendix giving the sensitivity and specificity of nearly 100 diagnostic tests, and a selective annotated bibliography directing the reader to significant articles in the current literature.

Clinicians are taught masses of facts, but not how to use them inthe messy reality of patient care. This book provides a missinglink between evidence and the clinical coalface. Though there areplenty of guides to evidence-based medicine, few explain how tobuild the information into patient oriented decision-making.Clinical Thinking allows you to think both logically andlaterally about daily clinical issues and look at problems fromdifferent angles. Uses realistic scenarios, frameworks and models Takes you through the whole decision-making process, fromobservation and narrative to evaluating the best evidence for theindividual situation Illustrations and flow charts help clarify this newapproach These methods have been tried and tested by the authors,internationally respected general practitioners and teachers inprimary care – all leaders in the evidence-based medicinemovement This book takes clinical medicine a big step forward in thedirection of patient-focused practice!

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