New PDF release: Medical Thinking: The Psychology of Medical Judgment and

By Steven Schwartz

ISBN-10: 1461249546

ISBN-13: 9781461249542

ISBN-10: 1461293731

ISBN-13: 9781461293736

Decision making is the physician's significant job. on a daily basis, in medical professionals' places of work through the global, sufferers describe their signs and com­ plaints whereas medical professionals practice examinations, order assessments, and, at the foundation of those information, come to a decision what's wrong and what will be performed. even supposing the method might sound routine-even to the physicians in­ volved-each step within the series calls for expert scientific judgment. Physicians needs to make a decision: which signs are vital, even if any laboratory assessments can be performed, how a number of the goods of medical information will be mixed, and, eventually, which of numerous remedies (including doing not anything) is indicated. even supposing a lot of the knowledge utilized in medical choice making is goal, the physician's values (a trust that soreness reduction is extra vital than strength habit to pain-killing medicines, for instance) and subjectivity are as a lot part of the scientific technique because the goal findings of laboratory checks. lately, either physicians and psychologists have come to gain that sufferer administration judgements should not purely subjective but additionally prob­ abilistic (although this isn't continuously stated overtly). while document­ tors argue that an operation in all fairness secure since it has a mortality fee of only one percent, they're at the least implicitly admitting that the result in their selection is predicated on probability.

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Read e-book online Medical Thinking: The Psychology of Medical Judgment and PDF

Choice making is the physician's significant job. each day, in medical professionals' places of work in the course of the international, sufferers describe their indicators and com­ plaints whereas medical professionals practice examinations, order exams, and, at the foundation of those info, come to a decision what's wrong and what may be performed. even if the method might sound routine-even to the physicians in­ volved-each step within the series calls for expert scientific judgment.

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Extra info for Medical Thinking: The Psychology of Medical Judgment and Decision Making

Example text

1978) found that physicians generate their initial hypotheses by correlating various clinical signs with their knowledge of patients and diseases, usually without a specific scientific rationale. Instead, the incidence of various diseases is the most important determinant of which hypotheses are considered. Once hypotheses are formulated, they may suggest others. Rarely are more than six or seven hypotheses considered at one time. Experienced diagnosticians are never without any hypothesis at all; if necessary, even vague notions can guide data collection.

In many cases, the risks are minor, but sometimes they are considerable. In either case, the ultimate decision about whether the risks are worth taking will rely on the patient's perceptions. These perceptions, in turn, depend on the type of information provided to the patient and the manner in which this information is presented. For example, Eraker and Politser (1982) described a study that found that patients who received more information about a drug's side effects than its benefits perceived it as more risky than those given more information about benefits than risks.

Similar results have been reported by others (Haynes, Sackett, & Tugwell, 1983; Kenney, 1981; Robertson, 1983; Toogood, 1980). 3 Range of Probabilities Associated with Verbal Modifiers by Physicians and Nonphysiciansa Range of Probability Verbal Estimates Physician Modifiers Nonphysician Not infrequently 45 60 40 50 May be associated 40 Often 59 39 39 Majority Common 38 40 35 45 Frequent Not unusual 30 35 30 Occasionally 33 30 65 Reported to occur Typical 30 30 Sometimes 27 35 Extremely common 25 28 Infrequent 29 25 Most 25 35 Usual 25 30 Characteristic 20 37 60 Invariably 20 18 Atypical 23 Unusual 15 22 15 Vast majority 23 9 9 Rare Very unusual 7 9 • Adapted from Nakao and Axelrod (1983, p.

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Medical Thinking: The Psychology of Medical Judgment and Decision Making by Steven Schwartz


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