Professional Judgment: A Reader in Clinical Decision Making

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Recent debate in both Europe and North America has focussed on how clinicians make judgments and decisions, how these may be evaluated and how they could be improved. This volume provides students, teachers and practitioners with a comprehensive introduction to the main descriptive and prescriptive approaches to judgment and decision making in clinical medicine. The contributors, who include psychologists, economists, decision theorists, statisticians, lawyers and sociologists, as well as medical specialists, provide examples of recent empirical research and its applications, as well as outlining the relevant concepts and theories. Policy-capturing models, data-based aids, expert ('knowledg-based') systems and decision analysis are the main techniques introduced, with attention to both their methodological bases and practical evaluation. Also included in the collection are a series of papers which consider the economic, ethical and legal contexts of clinical activity and the education and wider socialization of clinicians. Issues surrounding the 'cost-effective' use of resources, the obtaining of 'informed consent' from patients and ethical behaviour under uncertainty are highlighted.

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Editorial Reviews

From the Publisher
"The editors have done well in selecting some of the best papers that were available in the areas addressed." Medical Decision Making

"This book is an interesting presentation of the most promising research in clinical decision making by scholarly authors from various disciplines...The editors have provided as complete a book on clinical decision making as is currently available." The American Journal of Medicine

"Each essay is insightful, each is persuasive....No review can do justice to the complexities of the book....the interested reader is encouraged to examine the editors' introduction. This is a comprehensive overview of the contents of the book and a concise description of the present state of the field. After reading it, most readers will want to read the remainder of the book." Lee Roy Beach and Karl Halvor Teigen, Journal of Mathematical Psychology

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Product Details

  • ISBN-13: 9780521346962
  • Publisher: Cambridge University Press
  • Publication date: 1/1/1988
  • Pages: 584
  • Product dimensions: 5.98 (w) x 8.98 (h) x 1.30 (d)

Table of Contents

Editors' preface; Introduction; Part I. The Art and Science of Uncertainty: 1. variations in physician practice: the role of uncertainty D. M. Eddy; 2. From technical rationality to reflection-in-action D. A. Schön; 3. Clinical intuition and clinical analysis: expertise and the cognitive continuum R. M. Hamm; Part II. Modelling the Clinician and the Clinical Task: 4. Psychology of clinical reasoning A. S. Elstein and G. Bordage; 5. How physicians use clinical information in diagnosing pulmonary embolism: an application of conjoint analysis R. S. Wigton, V. L. Hoellerich and K. D. Patil; 6. You can't systematize human judgment: dyslexia R. M. Dawes; 7. Factors influencing the use of a decision rule in a probabilistic task H. R. Arkes, R. M. Dawes and C. Christensen; 8. Accepting error to make less error H. J. Einhorn; 9. Computer-aided diagnosis of acute abdominal pain: the British experience F. T. de Dombal; 10. The art of diagnosis: solving the clinicopathological exercise D. M. Eddy and C. H. Clanton; 11. Toward a theory of clinical expertise J. P. Kassirer, B. J. Kuipers and G. A. Gorry; 12. Formal and knowledge-based methods in decision technology J. Fox; Part III. The Decision Analytic Approach to Clinical Decisions: 13. Clinical decisionmaking P. Doubilet and B. J. McNeil; 14. Recurrent deep venous thrombosis in pregnancy: analysis of the risks and benefits of anticoagulation K. Klein and S. G. Pauker; 15. Comparison of physicians' decisions regarding estrogen replacement therapy for menopausal women and decisions derived from a decision analytic model A. S. Elstein, G. B. Holzman, M. M. Ravitch et al; 16. Hypothesis evaluation from a Bayesian perspective B. Fischhoff and R. Beyth-Marom; 17. Differential diagnosis and the competing-hypotheses heuristic: a practical approach to judgment under uncertainty and Bayesian probability F. M. Wolf, L. D. Gruppen and J. E. Billi; 18. Physicians' use of probabilistic information in a real clinical setting J. J. J. Christensen-Szalanski and J. B. Bushyhead; 19. Hindsight bias among physicians weighing the likelihood of diagnoses H. R. Arkes, P. D. Saville, R. L. Wortmann et al; 20. How decisions are reached: physician and patient S. A. Eraker and P. Politser; 21. The measurement of patients' values in medicine H. Llewellyn-Thomas, H. J. Sutherland, R. Tibshirani et al; 22. Clinical decision analysis B. Fischhoff; Part IV. The Contexts of Clinical Decisions: 23. Rationing hospital care: lessons from Britain W. B. Schwartz and H. J. Aaron; 24. resource allocation decisions inhealth care: a role for quality of life assessments? M. F. Drummond; 25. Economic evaluation of neonatal intensive care of very-low-birth-weight infants M. H. Boyle, G. W. Torrance, J. C. Sinclair and S. P. Horwood; 26. An analytic approach to resolving problems in medical ethics D. Candee and B. Puka; Commentary C. Fletcher; 27. Ethics and resource allocation: an economist's view A. McGuire; 28. Informed consent: court viewpoints and medical decision making D. J. Mazur; 29. Forgive and remember: managing medical failure C. L. Bosk; 30. Why doctors don't disclose uncertainty J. Katz.

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