Common-Sense Epidemiology in the Age of Electronic Patient Records (EPR)

2020 ◽  
pp. 343-364
Author(s):  
Shirly Bar-Lev ◽  
Dizza Beimel
Keyword(s):  
Decision Making ◽  
Common Sense ◽  
Clinical Information ◽  
Active Role ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Professional Help ◽  
Course Of Action ◽  
The Relationship ◽  
Practical Recommendations

Encouraging patients to play a more active role in their health care is crucial for healthcare planning and for the design of services. This chapter shifts the scholarly focus from practitioners' decision making to that of laypersons' trying to make sense of the lab results available on their EPRs. The authors developed a methodology to capture the relationship between information formats (graph, numeric, or verbal), laypersons' assessment of the conditions' gravity, and their preferred course of action. Focusing on the effect of “not knowing” on laypersons' preferred courses of action, our findings show that formats that left respondents less able to understand the results—namely, the numeric and verbal formats—produced a lower sense of urgency, and correspondingly, less inclination to actively seek professional help. The chapter takes a step toward deriving practical recommendations as to how personal clinical information should be communicated, to improve laypersons' interpretation of the information's significance.

The Role of Informed Consent in Medical Decision Making

2001 ◽  
Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Process Model ◽  
Clinical Care ◽  
Single Point ◽  
Accurate Information ◽  
Course Of Action ◽  
Potential Benefits ◽  
Event Model ◽  
The Relationship

How can informed consent be integrated into the physician-patient relationship in a manner that is respectful of both the idea of informed consent and the imperatives of clinical care? A realistic answer to that question could, we believe, remove much of the resistance of many healthcare professionals to the idea of informed consent. This chapter’s goal is to offer a practical procedural framework within which clinicians can operate to facilitate patients’ decision making in a manner that meets both these desiderata. The interactions of physicians and patients in making decisions about medical treatment can be conceptualized in two ways. Decision making can be approached as an event that occurs at a single point in time (an “event model”), or it can be viewed as a continuous element of the relationship between patients and their caregivers (a “process model”). The implications of these different ways of conceptualizing decisions about treatment are quite profound, rooted as they are in distinct visions of the relationship between physicians and patients. The event model of informed consent is predicated on a relatively simple paradigm. A patient seeking medical care approaches a physician for assistance. After assessing the patient’s condition, the physician reaches a diagnosis and formulates a recommended plan of treatment. The physician’s conclusions and recommendations are presented to the patient, along with information concerning the risks and potential benefits of the proposed treatment, and possible alternatives and their risks and potential benefits. Weighing the available data, the patient reflects on the relative risks and benefits of each course of action and then selects the medically acceptable alternative that most closely fits the patient’s particular values. On the surface at least, the event model conforms well to the legal requirements for informed consent. The event model emphasizes the provision of full and accurate information to patients at the time of decision making. Consent forms are often used for this purpose; indeed, the consent form can be said to be the central symbol of the event model (see Chapter 9). Patients’ understanding, although desirable in the abstract, is less crucial to this model than is the provision of information.

scholarly journals Switching Tracks? Towards a Multidimensional Model of Utilitarian Psychology

2020 ◽  
Author(s):  
Jim Albert Charlton Everett ◽  
Guy Kahane
Keyword(s):  
Decision Making ◽  
Common Sense ◽  
Moral Dilemmas ◽  
Multidimensional Model ◽  
Utilitarian Approach ◽  
Key Aspects ◽  
Common Sense Morality ◽  
The Relationship ◽  
Shed Light ◽  
Key Questions

Sacrificial moral dilemmas are widely used to investigate when, how, and why people make judgments that are consistent with utilitarianism. But to what extent can responses to sacrificial dilemmas shed light on utilitarian decision making? We consider two key questions: First, how meaningful is the relationship between responses to sacrificial dilemmas and what is distinctive of a utilitarian approach to morality? Second, to what extent do findings about sacrificial dilemmas generalise to other moral contexts where there is tension between utilitarianism and common-sense intuitions? We argue that sacrificial dilemmas only capture one point of conflict between utilitarianism and common-sense morality, and new paradigms are needed to investigate other key aspects of utilitarianism, such as its radical impartiality

Data-Driven Decision Making for New Drugs

2012 ◽  
pp. 144-162
Author(s):  
George P. Sillup ◽  
Ronald Klimberg ◽  
David P. McSweeney
Keyword(s):  
Decision Making ◽  
Healthcare Delivery ◽  
New Drugs ◽  
Pharmaceutical Marketing ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Real World Data ◽  
Collaborative Process ◽  
Pharmacy Claims ◽  
Student Teams

Two courses, advanced decision-making and pharmaceutical marketing, were combined in a collaborative process to mimic how the pharmaceutical industry determines the potential of new drugs. Integrated student teams worked together to complete semester-long projects and taught each other their respective knowledge areas—marketing and statistics. Real-world data for medical and pharmacy claims payments were “cleaned” and mined by students to analyze usage and cost patterns for anti-hypertensive and anti-hypercholesterolemia drugs currently on the market. Analyses included merging the medical and pharmaceutical data records to derive individual electronic patient records, which were the basis of financial projections for the new drugs. Importantly, the single patient record is congruent with the needs of the stakeholders currently working to reform U.S. healthcare delivery.

scholarly journals Mindfulness and decision-making: Sunk-costs or escalation of commitment?

2018 ◽  
Author(s):  
Neil Schmitzer-Torbert
Keyword(s):  
Decision Making ◽  
Sunk Costs ◽  
Escalation Of Commitment ◽  
Trait Mindfulness ◽  
Sunk Cost ◽  
Positive Health ◽  
Course Of Action ◽  
Cognitive Benefits ◽  
Positive Health Outcomes ◽  
The Relationship

Mindfulness is related to a number of positive health outcomes, such as decreased stress, anxiety and improved physical functioning. Recent studies have also identified a range cognitive benefits of mindfulness, including recent studies demonstrating that higher trait mindfulness and brief mindfulness inductions are associated with improved decision-making, and specifically to resistance to the influence of sunk-costs, where higher mindfulness is associated with increased willingness to discontinue a costly, but disadvantageous, course of action. However, some previous studies examining mindfulness and the sunk-cost bias have methodological limitations which make it difficult to determine if mindfulness is specifically related to sensitivity to the sunk-cost bias, or rather than to a general willingness to continue an unprofitable course of action (independent of the level of prior investment). The present study extends previous work by replicating the finding that trait mindfulness is positively related to resistance to the effects of sunk-costs, and also demonstrates that mindfulness is related to reduced escalation of commitment, an individual’s willingness to continue their commitment to a unprofitable course of action through the further investment of resources or time. Overall, trait mindfulness was most consistently related to reduced escalation of commitment, whereas the relationship between trait mindfulness and resistance to the effects of sunk-costs were less consistently observed

scholarly journals A Short History of Documenting Spiritual Care

2020 ◽  
pp. 11-20
Author(s):  
Simon Peng-Keller ◽  
David Neuhold
Keyword(s):  
Spiritual Care ◽  
Self Care ◽  
First Century ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Recent Developments ◽  
History Of ◽  
Spiritual Self ◽  
The Relationship

Abstract The first chapter of this edited volume traces the history of documenting spiritual care. By referring to ancient and early modern practices, the relationship between spiritual (self-) care and various forms of documentation is outlined. The focus lies on developments in the twentieth and the twenty-first century, although the question of what constitutes an adequate practice of documenting healthcare chaplaincy is as old as the profession itself. The pioneers of Clinical Pastoral Education (CPE) – Richard Cabot, Anton Boisen, Russell L. Dicks, and others – developed distinctive forms of recording for different purposes. For example, procedures of documentation that are prepared for and helpful to the pastors themselves as “self-criticism,” “self-improvement,” or even “self-revelation” have been distinguished from documentation practices that are intra- or interprofessional. Regarding more recent developments in documentation, the introduction of electronic patient records (EMRs) was critical. We present a case study from Kenya to show how the issues discussed here are encountered in a non-Euro-American context.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction

2019 ◽  
Vol 28 (2) ◽  
pp. 274-284 ◽  
Author(s):  
Elizabeth Convery ◽  
Gitte Keidser ◽  
Louise Hickson ◽  
Carly Meyer
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Clinical Decision Making ◽  
Hearing Aid ◽  
Well Being ◽  
Self Report ◽  
Self Management ◽  
Hearing Aid Benefit ◽  
The Relationship

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.

Centralization and Effectiveness of Reward Management in Multinational Enterprises

2018 ◽  
Vol 17 (2) ◽  
pp. 55-65 ◽  
Author(s):  
Michael Tekieli ◽  
Marion Festing ◽  
Xavier Baeten
Keyword(s):  
Decision Making ◽  
Social Identity Theory ◽  
Multinational Enterprises ◽  
Role Identity ◽  
Management Decision ◽  
Role Identities ◽  
Management Decision Making ◽  
New Perspective ◽  
Subsidiary Managers ◽  
The Relationship

Abstract. Based on responses from 158 reward managers located at the headquarters or subsidiaries of multinational enterprises, the present study examines the relationship between the centralization of reward management decision making and its perceived effectiveness in multinational enterprises. Our results show that headquarters managers perceive a centralized approach as being more effective, while for subsidiary managers this relationship is moderated by the manager’s role identity. Referring to social identity theory, the present study enriches the standardization versus localization debate through a new perspective focusing on psychological processes, thereby indicating the importance of in-group favoritism in headquarters and the influence of subsidiary managers’ role identities on reward management decision making.

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