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Author: Charles F. Manski
Publisher: Princeton University Press
ISBN: 0691194734
Category : Business & Economics
Languages : en
Pages : 184
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Book Description
For the past few years, the author, a renowned economist, has been applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. He shows how statistical imprecision and identification problems affect empirical research in the patient-care sphere.
Author: Charles F. Manski
Publisher: Princeton University Press
ISBN: 0691194734
Category : Business & Economics
Languages : en
Pages : 184
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Book Description
For the past few years, the author, a renowned economist, has been applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. He shows how statistical imprecision and identification problems affect empirical research in the patient-care sphere.
Author: Charles F. Manski
Publisher: Princeton University Press
ISBN: 0691195366
Category : Business & Economics
Languages : en
Pages : 184
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Book Description
How cutting-edge economics can improve decision-making methods for doctors Although uncertainty is a common element of patient care, it has largely been overlooked in research on evidence-based medicine. Patient Care under Uncertainty strives to correct this glaring omission. Applying the tools of economics to medical decision making, Charles Manski shows how uncertainty influences every stage, from risk analysis to treatment, and how this can be reasonably confronted. In the language of econometrics, uncertainty refers to the inadequacy of available evidence and knowledge to yield accurate information on outcomes. In the context of health care, a common example is a choice between periodic surveillance or aggressive treatment of patients at risk for a potential disease, such as women prone to breast cancer. While these choices make use of data analysis, Manski demonstrates how statistical imprecision and identification problems often undermine clinical research and practice. Reviewing prevailing practices in contemporary medicine, he discusses the controversy regarding whether clinicians should adhere to evidence-based guidelines or exercise their own judgment. He also critiques the wishful extrapolation of research findings from randomized trials to clinical practice. Exploring ways to make more sensible judgments with available data, to credibly use evidence, and to better train clinicians, Manski helps practitioners and patients face uncertainties honestly. He concludes by examining patient care from a public health perspective and the management of uncertainty in drug approvals. Rigorously interrogating current practices in medicine, Patient Care under Uncertainty explains why predictability in the field has been limited and furnishes criteria for more cogent steps forward.
Author: Lucia Siegel Sommers
Publisher: Springer Science & Business Media
ISBN: 1461468124
Category : Medical
Languages : en
Pages : 311
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Book Description
The Power of Colleagues What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients? .....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient? .....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations? .....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice? .....And where they are expected to practice coordinated, evidence-based, EMR-directed care These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone. From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and they present a cogent case for its special relationship to primary care practice...‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.
Author: Charles F. Manski
Publisher: Harvard University Press
ISBN: 0674067541
Category : Political Science
Languages : en
Pages : 218
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Book Description
Manski argues that public policy is based on untrustworthy analysis. Failing to account for uncertainty in an uncertain world, policy analysis routinely misleads policy makers with expressions of certitude. Manski critiques the status quo and offers an innovation to improve both how policy research is conducted and how it is used by policy makers.
Author: Avril Danczak
Publisher: Royal College of General Practitioners
ISBN: 0850844185
Category : Medical
Languages : en
Pages : 342
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Book Description
Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians, who fear they will make shameful or guilt inducing errors. This book offers a succinct method to clinicians for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully. Every clinician experiences moments when 'they don't know what to do'. Modern medicine is increasingly complex and training has also become more complicated. The days of 'see one, do one, teach one' are over. Yet, both younger clinicians and senior practitioners describe uncertainty as one of the most challenging and stressful aspects of clinical work. If uncertainty is uncomfortable or threatening to individual practitioners, it also provides complex educational challenges. How can we learn to cope with uncertainty effectively ourselves? How can we teach others to understand and manage uncertainty? In this ground breaking book, the authors propose ways to cut through uncertainty, which is explored as an inevitable (and even desirable) component of clinical practice. A Map of Uncertainty in Medicine (MUM) is used to classify uncertainty and to define the skills that will help find a way though practical difficulties. It is always good to have your MUM with you in a tricky situation!
Author: Robert E. Hall
Publisher: Princeton University Press
ISBN: 1400835267
Category : Business & Economics
Languages : en
Pages : 145
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Book Description
Individuals and families make key decisions that impact many aspects of financial stability and determine the future of the economy. These decisions involve balancing current sacrifice against future benefits. People have to decide how much to invest in health care, exercise, their diet, and insurance. They must decide how much debt to take on, and how much to save. And they make choices about jobs that determine employment and unemployment levels. Forward-Looking Decision Making is about modeling this individual or family-based decision making using an optimizing dynamic programming model. Robert Hall first reviews ideas about dynamic programs and introduces new ideas about numerical solutions and the representation of solved models as Markov processes. He surveys recent research on the parameters of preferences--the intertemporal elasticity of substitution, the Frisch elasticity of labor supply, and the Frisch cross-elasticity. He then examines dynamic programming models applied to health spending, long-term care insurance, employment, entrepreneurial risk-taking, and consumer debt. Linking theory with data and applying them to real-world problems, Forward-Looking Decision Making uses dynamic optimization programming models to shed light on individual behaviors and their economic implications.
Author: Kenneth Brigham
Publisher: Seven Stories Press
ISBN: 1609809971
Category : Medical
Languages : en
Pages : 181
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Book Description
What makes a good doctor? It's not what you think. A doctor willing to face their own uncertainty in the face of illness and treatment might just be the best medicine. Too often we choose the wrong doctor for the wrong reasons. It doesn't have to be that way. In The Good Doctor, Ken Brigham, MD, and Michael M.E. Johns, MD, argue that we need to change the way we think about health care if we want to be the healthiest we can be. Counterintuitive as it may seem, uncertainty is integral to medicine, and you want a doctor who knows that: someone who sees you as the unique case you are, someone who knows that data isn't everything, someone who is able to change her mind as the information changes. For too long we've clung to the myth of the infallible doctor--one who assuredly tells us this is what's wrong and here is how I will cure you--and our health has suffered for it. Brigham and Johns propose a new model of medicine, one that is comfortable with ambiguity and that centers on an equal partnership between patient and doctor. Uncertainty, properly embraced, opens a new universe of possibilities.
Author: Paul Seward Md
Publisher: Catapult
ISBN: 1936787903
Category : Biography & Autobiography
Languages : en
Pages : 192
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Book Description
Experience the real-life, high-stakes drama of emergency room care in 21 fascinating vignettes by a longtime ER physician. “Sad yet joyful, moving yet lighthearted . . . In the increasingly popular medical–memoir genre, this one stands out.” —Booklist Told in fast–paced, stand–alone chapters that recall unforgettable medical cases, Patient Care offers the fascination of medical mysteries, wrapped in the drama of living and dying. A snap judgment about a child nearly kills him, and a priest who may be having a heart attack refuses treatment. An asthmatic man develops air bubbles in his shoulders, and a pharmacist is haunted by a decision he makes. But the book goes beyond these stories. Each chapter explores ethical questions that remind us of the full humanity of patients, nurses, coroners, pharmacists, and, of course, doctors. How do they care for strangers in their moments of crisis? How do they care for themselves? Dr. Seward rejects doctor–as–God narratives to write frankly about moments of failure, and champions the role of his colleagues in health care. And, for all the moral dilemmas here, there is plenty of wit and humor, too. (See the patient who punches our doctor.) Readers of Patient Care will find themselves thinking along with Dr. Seward: “What is the right thing to do? What would I do?”
Author: Daniele Chiffi
Publisher: Springer Nature
ISBN: 3030590941
Category : Medical
Languages : en
Pages : 168
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Book Description
This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called “classical biomedical model of care”.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030921646X
Category : Medical
Languages : en
Pages : 217
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Book Description
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
