scholarly journals Technology of Supporting Medical Decision-Making Using Evidence-Based Medicine and Artificial Intelligence

2020 ◽  
Vol 176 ◽  
pp. 1703-1712
Author(s):  
Georgy Lebedev ◽  
Eduard Fartushnyi ◽  
Igor Fartushnyi ◽  
Igor Shaderkin ◽  
Herman Klimenko ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Evidence Based Medicine ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Evidence Based ◽  
Based Medicine

‘Evidence-based’, ‘Cost-Effective’ and ‘Preference-Driven’ Medicine: Decision Analysis Based Medical Decision Making is the Pre-Requisite

1996 ◽  
Vol 1 (2) ◽  
pp. 104-113 ◽  
Author(s):  
Jack Dowie
Keyword(s):  
Decision Making ◽  
Decision Analysis ◽  
Evidence Based Medicine ◽  
Medical Decision Making ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Medical Decision ◽  
Evidence Based ◽  
Meta Analyses ◽  
Based Medicine

Three broad movements are seeking to change the world of medicine. The proponents of ‘evidence-based medicine’ are mainly concerned with ensuring that strategies of proven clinical effectiveness are adopted. Health economists are mainly concerned to establish that ‘cost-effectiveness’ and not ‘clinical effectiveness’ is the criterion used in determining option selection. A variety of patient support and public interest groups, including many health economists, are mainly concerned with ensuring that patient and public preferences drive clinical and policy decisions. This paper argues that decision analysis based medical decision making (DABMDM) constitutes the pre-requisite for the widespread introduction of the main principles embodied in evidence-based medicine, cost-effective medicine and preference-driven medicine; that, in the light of current modes of practice, seeking to promote these principles without a prior or simultaneous move to DABMDM is equivalent to asking the cart to move without the horse; and that in fact DABMDM subsumes and enjoins the valuable aspects of all three. Particular attention is paid to differentiating between DABMDM and EBM, by way of analysis of various expositions of EBM and examination of two recent empirical studies. EBM, as so far expounded, reflects a problem-solving attitude that results in a heavy concentration on RCTs and meta-analyses, rather than a broad decision making focus that concentrates on meeting all the requirements of a good clinical decision. The latter include: Ensuring that inferences from RCTs and meta-analyses to individual patients (or patient groups) are made explicitly; paying equally serious attention to evidence on values and costs as to clinical evidence; and accepting the inadequacy of ‘taking into account and bearing in mind’ as a way of integrating the multiple and distinct elements of a decision.

scholarly journals Use of Evidence in Acute Stroke Decision-Making: Implications for Evidence-Based Medicine

2021 ◽  
Author(s):  
Timothe Langlois-Therien ◽  
Brian Dewar ◽  
Ross Upshur ◽  
Michel Shamy
Keyword(s):  
Decision Making ◽  
Evidence Based Medicine ◽  
Best Practice ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Evidence Based ◽  
Physician Decision Making ◽  
Prescriptive Model ◽  
Based Medicine

Evidence-Based Medicine proposes a prescriptive model of physician decision-making in which “best evidence” is used to guide best practice. And yet, proponents of EBM acknowledge that EBM fails to offer a systematic theory of physician decision-making. In this paper, we explore how physicians from the neurology and emergency medicine communities have responded to an evolving body of evidence surrounding the acute treatment of patients with ischemic stroke. Through analysis of this case study, we argue that EBM’s vision of evidence-based medical decision-making fails to appreciate a process that we have termed epistemic evaluation. Namely, physicians are required to interpret and apply any knowledge — even what EBM would term “best evidence” — in light of their own knowledge, background and experience. This is consequential for EBM as understanding what physicians do and why they do it would appear to be essential to achieving optimal practice in accordance with best evidence.

Evidence-Based Medicine

2006 ◽  
Vol 96 (4) ◽  
pp. 374-377 ◽  
Author(s):  
Marvin H. Waldman
Keyword(s):  
Decision Making ◽  
Patient Preferences ◽  
Evidence Based Medicine ◽  
Medical Decision Making ◽  
Clinical Care ◽  
Medical Decision ◽  
Evidence Based ◽  
Clinical Intuition ◽  
Pros And Cons ◽  
Based Medicine

The purpose of this article is to review the history and development of evidence-based medicine, to provide a basic outline of its application to clinical care, and to discuss its pros and cons. This article can be used as a tool in podiatric medicine and surgery to ensure that current best evidence, clinical intuition, and patient preferences inform and guide our medical decision making. (J Am Podiatr Med Assoc 96(4): 374–377, 2006)

scholarly journals Impact of deliberate practice on evidence-based medicine attitudes and behaviours of health care professionals

2020 ◽  
Author(s):  
Eelco Draaisma ◽  
Lauren A. Maggio ◽  
Jolita Bekhof ◽  
A. Debbie C. Jaarsma ◽  
Paul L. P. Brand
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Research ◽  
Health Care Professionals ◽  
Evidence Based Medicine ◽  
Deliberate Practice ◽  
Medical Decision ◽  
Evidence Based ◽  
Teaching Activities ◽  
Based Medicine

Abstract Introduction Although evidence-based medicine (EBM) teaching activities may improve short-term EBM knowledge and skills, they have little long-term impact on learners’ EBM attitudes and behaviour. This study examined the effects of learning EBM through stand-alone workshops or various forms of deliberate EBM practice. Methods We assessed EBM attitudes and behaviour with the evidence based practice inventory questionnaire, in paediatric health care professionals who had only participated in a stand-alone EBM workshop (controls), participants with a completed PhD in clinical research (PhDs), those who had completed part of their paediatric residency at a department (Isala Hospital) which systematically implemented EBM in its clinical and teaching activities (former Isala residents), and a reference group of paediatric professionals currently employed at Isala’s paediatric department (current Isala participants). Results Compared to controls (n = 16), current Isala participants (n = 13) reported more positive EBM attitudes (p < 0.01), gave more priority to using EBM in decision making (p = 0.001) and reported more EBM behaviour (p = 0.007). PhDs (n = 20) gave more priority to using EBM in medical decision making (p < 0.001) and reported more EBM behaviour than controls (p = 0.016). Discussion Health care professionals exposed to deliberate practice of EBM, either in the daily routines of their department or by completing a PhD in clinical research, view EBM as more useful and are more likely to use it in decision making than their peers who only followed a standard EBM workshop. These findings support the use of deliberate practice as the basis for postgraduate EBM educational activities.

scholarly journals "Doctor Knows Best"

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Dylan Mirek Popowicz
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Evidence Based ◽  
Patient Relationship ◽  
Medical Practitioners ◽  
Making Sense ◽  
Decision Making Processes ◽  
Based Medicine

We often consider medical practitioners to be epistemic authorities: “Doctor knows best,” as the saying goes. The place of expert judgment in evidence-based medicine hierarchies, and the crucial role of patient preferences and values in medical decision-making, however, pose problems for making sense of such authority. I argue that there is an account of such medical epistemic authority that does justice to the complexities of the doctor–patient relationship, while maintaining that medical practitioners hold an epistemically privileged position. Such a view can better inform medical practice by clearly illuminating the distinct roles of patients and doctors in decision-making processes.

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