|Title||Decision analysis and clinical judgment|
|Author(s)||William B. Schwartz; G. Anthony Gorry; Jerome P. Kassirer; Alvin Essig|
|Source||Am J Med, Vol. 55, Pages 459-472|
|Publication Date||Oct. 1973|
|Abstract||Sound clinical judgments derive both from the command of a sufficient body of facts and from the skill to combine such facts appropriately. Most undergraduate and graduate medical education concentrates on the first of these elements, the acquisition of knowledge; little formal effort is directed to the logic of dealing with clinical problems. |
In this discussion we suggest that the theory and technics of decision analysis provide new and useful strategies appropriate for dealing with complex clinical situations. In their qualitative aspects these formal strategies closely resemble those that the expert clinical employs informally, but which he is often unable to communicate explicitly. When applied quantitatively, the formalist affords greater precision than is otherwise readily attainable.
To illustrate this application and utility of decision analysis we have considered the problems posed by severely hypertensive patients with possible functional renal artery stenosis, and have examined, both qualitatively and quantitatively, the alternative courses of action available to the clinician.