Evidence-Based Medicine With Patient’s Preferences Essay

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Decision analysis

The professionals in medicine or clinical practice are often faced by difficulties in choosing from a set of options that define different courses of actions. Difficulties encountered in such cases are mainly caused by the uncertainties associated with each of the options that are aimed at improving the health of a patient. The treatment options available for use by a medical practitioner have potential harms as well as benefits to the patient. In order to make a decision on which treatment option to apply, the practitioner has to conduct an analysis of the harms and benefits of each of the available options (Aleem, Schemitsch, and Hanson, 2008). Care has to be taken when seeking for information upon which the decisions will be made since the decision will have a lone term effects on the health of the patient.

Lack of resources and proper information has resulted into poor decision-making processes that have been witnessed in certain instances. It has been observed that in several decision-making cases where there is no proper clinical evidence, “the choices appear to be made based on the intuition [of the practitioner] than a rational weighing of the outcomes and probabilities” (Aleem, Schemitsch, and Hanson, 2008). This often leads to very negative results in the complex situations. Therefore, it is important to understand that, “just like businessmen and persons in other organizations, clinicians are required to choose a course of actions from among various strategic alternatives” (Detsky, 1987, p.322).

Decision analysis involves an examination of the advantages and disadvantages of all the treatment options that are available. According to an article titled Decision Analysis (N.d, p.2) “decision analysis is a logical and systematic way to address a wide variety of problems involving decision making in an uncertain environment.” It involves the application of evidence-based medicine to enable a clinician to come up with the appropriate treatment option that can be used on a given patient. Before the option can be implemented, it is important to examine the factors that are specific to the patient. The available resources as well as the preference of the patients need to be considered to have effective treatment. For instance, consider an individual who has had a displaced femoral neck facture. It is observed that the individual can be subjected to two treatment options, arthroplasty, or internal fixation (Aleem, Schemitsch, and Hanson, 2008). Researches have indicated that the former is favored over the latter. However, the patient had witnessed a situation where another relative suffered joint stiffness after undergoing arthroplasty. He is traumatized by the same, thereby preferring the other option. If the clinician does not seek the preference of the patient, then the treatment option adopted can be of adverse health effect to the patient. Thus, effective decision analysis involves merging the evidence-based medicine and the preference of the patient.

Discussion board by Valerie

Decision-making processes, even in the clinical practice, are made under some uncertainties. The discussion here illustrates the prime role that Bayesian statistics play in making decisions under these uncertain conditions. However, the group fails to provide a succinct example of a situation that involves application of Bayesian probabilities in decision analysis. The Bayesian probabilities are essential in determining the possibility of occurrence of some medical condition that requires an intervention. This is then considered alongside the weights given to the outcomes of each possible intervention to come up with an appropriate decision.

Discussion board by Marthe

The discussion by this group provides an appropriate emphasis on the role that the preference of a patient play in making decisions concerning the right mode of treatment. In deed, it is true that each of the patients suffering from some form of illness have unique characters. In this respect, an effective decision analysis provides a flexible approach that enables an application of the clinical data to different patients owing to the diversity in their character or preferences.

As illustrated in the discussion, the first step in decision analysis is to gather data pertaining to different patients and conditions that can be used as evidence for the case under study. It is then necessary to categorize the evidences as per the cases observed. The positive and negative consequences of each the possible interventions are evaluated. Finally, a decision will be made after considering the patients preference. As such, evidence-based medicine is reconciled with the patient’s preference in the decision analysis. The example provided here illustrates how the patient’s preference will be incorporated into the analysis.

References

Aleem, I., Schemitsch, E. and Hanson, B. (2008). What is a clinical decision analysis study? Indian Journal of Orthopedics, Vol. 42, Issue, 2; pp 137-139. Web.

Decision Analysis. (N.d). Decision Analysis. Web.

Detsky, A. (1987). Decision Analysis: What’s the Prognosis? Annals of Internal Medicine, Vol. 106, Issue 2; pp. 321-322. Web.

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