Clinical Decision Making

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• Introduction to Clinical Decision Making
  • General reference

• Evidence-Based Medicine and Clinical Guidelines
  • Evidence-Based Medicine
    • Formulating a clinical question
    • Gathering evidence to answer the question
    • Evaluating the quality and validity of the evidence
    • Deciding how to apply the evidence to the care of a given patient
    • Limitations of the evidence-based approach
  • Clinical Guidelines

• Clinical Decision-Making Strategies
  • Hypothesis Generation
    • Probability and odds
  • Hypothesis Testing
  • Probability Estimations and the Testing Threshold
  • Probability Estimations and the Treatment Threshold
    • Limitations of quantitative decision methods

• Cognitive Errors in Clinical Decision Making
  • Types of Cognitive Error
    • Availability error
    • Representation error
    • Premature closure
    • Anchoring errors
    • Confirmation bias
    • Attribution errors
    • Affective error
  • Risk Factors for Cognitive Error
  • Minimizing cognitive errors

• Understanding Medical Tests and Test Results
  • Defining a Positive Test Result
    • Receiver operating characteristic (ROC) curves
  • Test Characteristics
    • Sensitivity, specificity, and predictive values
    • Likelihood ratios (LRs)
  • Dichotomous Tests
    • Pre-test probability
  • Continuous Tests
  • Bayes Theorem
    • Odds-likelihood calculation
    • Odds-likelihood nomogram
    • Tabular approach
  • Sequential Testing
  • Screening Tests
    • Multiple screening tests
  • Testing Thresholds

• Economic Analyses in Clinical Decision Making
  • Cost
    • Marginal cost
  • Outcome
    • Quality-adjusted life year (QALY)
    • Number needed to treat
    • Clinically vs statistically significant outcome
  • Cost-Benefit Analysis
    • Marginal cost-effectiveness ratio

• Electronic Health Records (EHR) and Clinical Decision Support
  • References
  • More Information