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Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing the resources required. This text takes a proactive, systematic and rational approach to medical decision making. It covers decision trees, Bayesian revision, receiver operating characteristic curves, and cost-effectiveness analysis; as well as advanced topics such as Markov models, microsimulation, probabilistic sensitivity analysis and value of information analysis. It provides an essential resource for trainees and researchers involved in medical decision modelling, evidence-based medicine, clinical epidemiology, comparative effectiveness, public health, health economics, and health technology assessment.


Author by : M. G. Myriam Hunink
Category : Medical
Publisher by : Cambridge University Press
Language : en
Release : 2014-10-16
Total Download :405
Total Read :1467
Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing the resources required. This text takes a proactive, systematic and rational approach to medical decision making. It covers decision trees, Bayesian revision, receiver operating characteristic curves, and cost-effectiveness analysis, as well as advanced topics such as Markov models, microsimulation, probabilistic sensitivity analysis and value of information analysis. It provides an essential resource for trainees and researchers involved in medical decision modelling, evidence-based medicine, clinical epidemiology, comparative effectiveness, public health, health economics, and health technology assessment.

Author by : Stefan Felder
Category : Business & Economics
Publisher by : Springer Science & Business Media
Language : en
Release : 2011-07-22
Total Download :362
Total Read :1677
This textbook offers a comprehensive theory of medical decision making under uncertainty, combining informative test theory with the expected utility hypothesis. 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 result is determined by the decision maker. Finally, 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 become endogenous.

Author by : Marthe R. Gold
Category : Medical
Publisher by : Oxford University Press
Language : en
Release : 1996-07-18
Total Download :647
Total Read :2763
A unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEAs) as decision-making aids in the health and medical fields, this volume is the product of over two years of comprehensive research and deliberation by a multi-disciplinary panel of economists, ethicists, psychometricians, and clinicians. Exploring cost-effectiveness in the context of societal decision-making for resource allocation purposes, this volume proposes that analysts include a "reference-case" analysis in all CEAs designed to inform resource allocation and puts forth the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, evaluating outcomes, discounting, and dealing with uncertainty are examined in separate chapters. Additional chapters on framing and reporting of CEAs elucidate the purpose of the analysis and the effective communication of its findings. Cost-Effectiveness in Health and Medicine differs from the available literature in several key aspects. Most importantly, it represents a consensus on standard methods--a feature integral to a CEA, whose principal goal is to permit comparisons of the costs and health outcomes of alternative ways of improving health. The detailed level at which the discussion is offered is another major distinction of this book, since guidelines in journal literature and in CEA-related books tend to be rather general--to the extent that the analyst is left with little guidance on specific matters. The focused overview of the theoretical background underlying areas of controversy and of methodological alternatives, and, finally, the accessible writing style make this volume a top choice on the reading lists of analysts in medicine and public health who wish to improve practice and comparability of CEAs. The book will also appeal to decision-makers in government, managed care, and industry who wish to consider the uses and limitations of CEAs.

Author by : Harold C. Sox
Category : Medical
Publisher by : John Wiley & Sons
Language : en
Release : 2013-05-08
Total Download :675
Total Read :1130
This book clearly demonstrates how to best make medical decisions while incorporating clinical practice guidelines and decision support systems for electronic medical record systems. New to this edition is how medical decision making ideas are being incorporated into clinical decision support systems in electronic medical records and also how they are being used to shape practice guidelines and policies.

Author by : Glyn Elwyn
Category : Medical
Publisher by : Oxford University Press
Language : en
Release : 2016-07-21
Total Download :821
Total Read :1079
Over the past decade health care systems around the world have placed increasing importance on the relationship between patient choice and clinical decision-making. In the years since the publication of the second edition of Shared Decision Making in Health Care, there have been significant new developments in the field, most notably in the US where 'Obamacare' puts shared decision making (SDM) at the centre of the 2009 Affordable Care Act. This new edition explores shared decision making by examining, from practical and theoretical perspectives, what should comprise an effective decision-making process. It also looks at the benefits and potential difficulties that arise when patients and clinicians share health care decisions. Written by leading experts from around the world and utilizing high quality evidence, the book provides an up-to-date reference with real-word context to the topics discussed, and in-depth coverage of the practicalities of implementing and teaching SDM. The breadth of information in Shared Decision Making in Health Care makes it an essential resource for policy-makers and health care workers. As health care systems adapt to increasingly collaborative patient-clinician care frameworks, this will also prove a useful guide to SDM for clinicians of all disciplines.

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