From Medical Data to Health Knowledge

1987 ◽  
Vol 26 (01) ◽  
pp. 3-12 ◽  
Author(s):  
J. M. Martin ◽  
L. Benamghar ◽  
B. Junod ◽  
P. Marrel
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Health Knowledge ◽  
Medical Information ◽  
Computer Systems ◽  
Medical Knowledge ◽  
Medical Data ◽  
Medical Decision ◽  
Decision Making Process ◽  
The Way

SummaryThe problems of assisting in the medical decision-making process are attracting more and more attention.Actually a certain number of computer systems have considerably improved the availability of medical data. However, we encounter some difficulties when extending these systems. In order to surmount these problems, it is necessary to proceed further in the analysis and comprehension of medical information and processes.To accomplish this goal, it is necessary to have a better understanding of the way in which a group of medical data is derived from one piece of medical knowledge and also how a chunk of medical knowledge is related to its corresponding medical data.This article is a beginning in the study of the transition from medical data to health knowledge, and this transition represents only part of the global entity, the nature, the representation, and use of medical information.

Support for management medical decisions and the nature of uncertainty in them

2021 ◽  
Author(s):  
S.Yu. Zhuleva ◽  
A.V. Kroshilin ◽  
S.V. Kroshilina
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Information ◽  
General Scheme ◽  
The Body ◽  
Medical Decision ◽  
Problem Situation ◽  
Medical Decisions ◽  
Inaccurate Information ◽  
Individual Decisions

The process of making a medical decision is characterized by a lack of knowledge and inconsistency of the available information, the lack of the possibility of attracting competent medical experts, limited time resources, incomplete or inaccurate information about the patient's condition. These aspects may be the causes of medical errors, which lead to further aggravation of the problem situation. Purpose – it is necessary to define and justify managerial medical decisions and types of medical information in conditions of uncertainty, when each variant of the sets of outcomes of the situation (recommendations) has its own unique set of values. The fundamental difference between this process for medical use is the concept of the "best medical solution", in which the key role is given to the patient's state of health in obtaining and evaluating alternatives, as well as the need to take into account the time, adverse reactions of the body and the costs of implementing this solution. In the medical field, support for medical decision-making can be classified as organizational-managerial and therapeutic-diagnostic, but both are determined by the position of the person making the medical decision and are aimed at effective management of the medical institution as a whole. The article describes the causes and factors of the nature of uncertainty in the tasks of supporting medical decision-making in medical-diagnostic and organizational-managerial areas. The analysis of the features of supporting medical decision-making in conditions of uncertainty is carried out. Approaches and directions in this area, as well as the concept of “solution”, are considered. The essence of the management medical decision is reflected. The classification of management medical decisions is given, the requirements that are imposed on them are highlighted. The features of the development of management medical solutions in the conditions of incompleteness and uncertainty, the problems that arise when they are implemented in information systems are presented. The general scheme of the process of creating a management medical solution is shown. The features of making group and individual decisions are reflected. The algorithm of actions of the person making the medical decision in the conditions of uncertainty, incompleteness and risk in medical subject areas is presented.

scholarly journals Culture, Self, and Medical Decision Making in Australia and China: A Structural Model Analysis

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831987101 ◽  
Author(s):  
Hankiz Dolan ◽  
Dana L. Alden ◽  
John M. Friend ◽  
Ping Yein Lee ◽  
Yew Kong Lee ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Information ◽  
Personal Values ◽  
Total Variance ◽  
Medical Decision ◽  
Equation Modeling ◽  
Individual Level ◽  
Study Results ◽  
Variance Explained

Objective. To explore and compare the influences of individual-level cultural values and personal attitudinal values on the desire for medical information and self-involvement in decision making in Australia and China. Methods. A total of 288 and 291 middle-aged adults from Australia and China, respectively, completed an online survey examining cultural and personal values, and their desired level of self-influence on medical decision making. Structural equation modeling was used to test 15 hypotheses relating to the effects of cultural and personal antecedents on the individual desire for influence over medical decision making. Results. Similar factors in both Australia and China (total variance explained: Australia 29%; China 35%) predicted desire for medical information, with interdependence (unstandardized path coefficient βAustralia = 0.102, P = 0.014; βChina = 0.215, P = 0.001), independence (βAustralia = 0.244, P < 0.001; βChina = 0.123, P = 0.037), and health locus of control (βAustralia = −0.140, P = 0.018; βChina = −0.138, P = 0.007) being significant and positive predictors. A desire for involvement in decisions was only predicted by power distance, which had an opposite effect of being negative for Australia and positive for China (total variance explained: Australia 11%; China 5%; βAustralia = 0.294, P < 0.001; China: βChina = −0.190, P = 0.043). National culture moderated the effect of independence on desire for medical information, which was stronger in Australia than China ( Z score = 1.687, P < 0.05). Conclusions. Study results demonstrate that in both countries, desire for medical information can be influenced by individual-level cultural and personal values, suggesting potential benefits of tailoring health communication to personal mindsets to foster informed decision making. The desired level of self-involvement in decision making was relatively independent of other cultural and personal values in both countries, suggesting caution against cultural stereotypes. Study findings also suggest that involvement preferences in decision making should be considered separately from information needs at the clinical encounter.

Incorporating patient preferences and priorities into end-of-life care.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 41-41
Author(s):  
Eric Rackow ◽  
Afua Ofori ◽  
Wendy Rodkey ◽  
Roy A. Beveridge
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
End Of Life Care ◽  
Medical Decision Making ◽  
Case Managers ◽  
Readiness For Change ◽  
Medical Decision ◽  
Decision Making Process ◽  
Life Care

41 Background: Patients with advanced illness often face painful conversations and difficult decisions. A program was deployed to help patients identify, communicate, and incorporate their personal preferences and priorities into decisions about their care. The program was assessed by measuring movement along the readiness for change continuum. Methods: Patients residing in the home and participating in a chronic care program were referred by their case managers based on clinical conditions and whether the patient appeared to be in their last 12 months of life. Counseling sessions with patients or family caregiver/s were designed to move participants toward the following actions: be fully informed about their medical situation, describe their detailed quality of life priorities, articulate a self-defined medical decision making process, effectively communicate to their family and physicians, and implement and repeat the aforementioned steps. After 5 months (Sept-2014 to Feb-2015), movement along the readiness for change continuum (pre-contemplation, contemplation, preparation, action, maintenance, and advocacy) was reported. Results: Of the 427 patients referred, 33 could not be reached, 116 were ineligible, 50 declined or did not engage. Of the 228 participants, 191 (84%) moved at least one step in readiness for change continuum over the 5-month period. In Nov-2014, 13% of participants were in action, maintenance, or advocacy, which increased to 19% by Feb-2015. The largest observed movement to action, maintenance, or advocacy was in defining quality of life priorities: 2% Nov-2014 to 21% Feb-2015. The least movement to action, maintenance, or advocacy was observed in articulating a self-defined medical decision making process: 3% Nov-2014 to 16% Feb-2015. Case managers reported discomfort in referring members based on their assessment of length of life. Early surveys show high levels of satisfaction. Conclusions: A very high percentage of patients progressed in incorporating their preferences and priorities into end of life care as measured by the readiness to change continuum. This program is currently expanding and the referral process is changing from case manager to algorithm based identification referrals.

scholarly journals Application of a computerized medical decision-making process to the problem of digoxin intoxication

1984 ◽  
Vol 4 (3) ◽  
pp. 571-576 ◽  
Author(s):  
Keith S. White ◽  
Alan Lindsay ◽  
T. Allan Pryor ◽  
Wayne F. Brown ◽  
Kevin Walsh
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Process ◽  
Digoxin Intoxication

scholarly journals The role of non-medical factors in physicians’ decision-making process in a pediatric telemedicine service

2019 ◽  
Vol 26 (2) ◽  
pp. 1152-1176 ◽  
Author(s):  
Motti Haimi ◽  
Shuli Brammli-Greenberg ◽  
Yehezkel Waisman ◽  
Nili Stein ◽  
Orna Baron-Epel
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decision Making Process ◽  
Medical Decisions ◽  
Telemedicine Service ◽  
Medical Factors ◽  
Complex Process ◽  
Clinical Scenarios

The complex process of medical decision-making is prone also to medically extraneous influences or “non-medical” factors. We aimed to investigate the possible role of non-medical factors in doctors’ decision-making process in a telemedicine setting. Interviews with 15 physicians who work in a pediatric telemedicine service were conducted. Those included a qualitative section, in which the physicians were asked about the role of non-medical factors in their decisions. Their responses to three clinical scenarios were also analyzed. In an additional quantitative section, a random sample of 339 parent -physician consultations, held during 2014–2017, was analyzed retrospectively. Various non-medical factors were identified with respect to their possible effect on primary and secondary decisions, the accuracy of diagnosis, and “reasonability” of the decisions. Various non-medical factors were found to influence physicians’ decisions. Those factors were related to the child, the applying parent, the physician, the interaction between the doctor and parents, the shift, and to demographic considerations, and were also found to influence the ability to make an accurate diagnosis and “reasonable” decisions. Our conclusion was that non-medical factors have an impact on doctor’s decisions, even in the setting of telemedicine, and should be considered for improving medical decisions in this milieu.

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