Medical Decision Making

Fascinating book. I'm a surgeon and most of the examples are internal medicine but very very worthwhile.

Good first few chapters, but it gets more technical than I'd like (for students) further on.

The BEST introduction to the field. I have been using it my teaching for years. Clear and concise. Well presented.

A good book for introductory reading

Very very useful. Very novel brilliant script and theory

Good deal

This is an excellent book. It will help practising doctors and medical students to come to understand what they are doing in their work with greater clarity and depth. It will also help statisticians and others who study and try to understand, manage and guide how doctors think and act to achieve this more successfully, and in a way that that concepts such as Knowledge Translation in Health Care: Moving from Evidence to Practicemiss completely.In medicine we basically get two things wrong with our work- the words and the numbers. We get our communication wrong, partly because we don't actually understand the numerical substructure of our medical thinking. We often talk about vaguely numerical ideas such as "some" or "mostly" or "usually" and we often don't really think out what exact numbers we are talking about. We can confuse ourselves at many levels- from individual consultations to the maths involved in high powered academic research. Wherever the statisticians look in medicine (and in many other fields) they can have great fun finding basic mathemetical errors in our thought processes.This book is written by experienced authors who approach their work from the point of view of practising doctors who are answering questions about and to their patients. They are looking at basic diagnostic processes that actual doctors use, and their strengths and weaknesses. They show well how doctors operate basically as Bayesian thinkers, adjusting their prior estimates of the probability and improbablity of diagnoses as new information becomes available. They help us to do this process consciously and well, and suggest refinements to our well honed pattern recognition schemas- ways of checking their accuracy, cross referencing, looking for disconfirmation, when our accuracy is sufficient for action and when it is dangerously askew. As a medical student you'd read this as an introduction. As a medical junior doctor (resident) you'd read it and recognise the steps being used, as a senior doctor you'd read it and realise what exactly you are doing in your work.The maths behind our diagnostic thinking is well described. What becomes obvious is how many complex calculations doctors make in a scenario- and we do this not in a mathematical way but by integrating inputs from amny sources- the patient, experience, reviews, guidelines etc. We are actually using many mathematical structures unconsciously. When you read this book you become more conscious of what you are doing and achieving each day. In many ways as humans we cannot not be mathematical or philosophical- when you stop and really think about how you are doing an activity you by definition are using a mathematical and philosophical structure- and you can only deny this...by another mathematical or philosphical gambit.As a doctor this is a great book to help you become clearer about your work and thought processes. it goes alongside other medical classics that are about how we go about our work rather than the work itself. I'd rate it highly- alongside classics such as Clinical Epidemiology: How to Do Clinical Practice Research (CLINICAL EPIDEMIOLOGY (SACKETT)) and Patient Safety and The Human Contribution: Unsafe Acts, Accidents and Heroic Recoveries

第一版からもう何年経っているだろうか。最近はやりの臨床推論や、臨床判断ルールなどの基礎が書いてある。内容はあまり変わっていないところも多いけど、データベースや電子カルテなどの応用などにもコメントされている。基本を知ることが重要と思う人は読むべき。逸話を積み重ねても、なかなか理論は分からないので。

Ultra hardcore on the stats front, definitely a lot more than I expected and therefore, while I persevered, I no doubt didn't get the full content out of this that someone who has a need to read this would.Can't knock the content and presentation, as both were impeccable, but I'd suggest if you have come to this page you probably already know what this book contains and thus my review will make little difference!

The first thing I should point out is that this is a rigorous maths book and not a layman's guide to making decisions. This is a book that goes into the intricate mathematical details of Bayesian Decision Theory and puts decision making on a sound mathematical basis. Having said this as one reviewer stated. No matter how complex your decision system the human always comes into it and people make decisions based on intuition and feelings.So this is not a book that doctors should have on their shelves to influence how they prescribe or how they treat patients. But it is a book that should be on every NHS senior administrator's desk to say how and why they should make certain strategic decisions. It should be read by all regulators, everyone in regulatory affairs and everyone in research.While it does dive into the deep maths of Bayes and complex statistical models it does so in a very visual way, and it is a lot more accessible than the standard decision theory text. But light reading and a simple practical guide it is not. The price of rigor is complexity.

This almost 350 page paperback is a second edition and is dated 2013 so this volume is bang-up-to-date.The size of the book is a lot easier to read from then most medical textbooks but the inside lacks colour. Whilst there are a great number of flow charts, graphs, tables, etc, the black and white nature doesn't draw the reader in.However, the headings and subheadings make it very easy to find the information you're looking for, allowing the book to be used as a reference guide. With a good index of subjects and sections at the front as well as the standard index at the back, you will find what you want in this book quickly.The book takes the medic through a process of discussing how data may be gathered, interpreted and considered. It also discusses using new methods and evaluating their risks and effectiveness.There are chapters on differential diagnosis, probability, Bayes' theorem, the accuracy of tests and measuring outcomes. There is also a discussion of the cost effectiveness of tests and treatments.This book is well written and readable, yet it is constructed in a purely academic style. A greater consideration of drawing the eye to the page and making them more interesting and colourful would have been a plus.It is an important area of medicine but the book covers a lot of medical statistics, beyond the level of a medical undergraduate, but good for reference and a more academically suited mind.A useful text for any medics bookshelf.

This book is a second edition. The first was well received in its time but it needed updating, and this edition now meets modern needs, with its emphasis on helping patients to make decisions rather than making those decisions for them. If it has a weakness, it says relatively little about the language that could convey the facts to the patient in a way that equips them to make the necessary decision. Nevertheless, as a description of decision making techniques this book takes some beating.