Assessing Clinical Decision Making

Is the Ideal System Feasible?

by Robert W. Dubois, Robert H. Brook

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While caring for patients, physicians make a variety of decisions. Can current methods adequately determine whether these decisions are correct? If not, what improvements are needed? This paper begins with a review of several explicit methods to assess physician decisionmaking. It then describes a more comprehensive system that would use Bayesian logic to assess whether a physician responded appropriately to the needs of an individual patient. Although sophisticated branching logic may be theoretically desirable, it may not be feasible. The authors conclude by proposing an explicit, potentially practical method that would judiciously use branching logic.

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