经济学评价在临床决策中的应用探讨

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程。制定决策的整个过程,同时也是进行决策思维的过程。近年来,高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂。如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性具有重要的现实意义。     

经济学评价在临床决策中的应用探讨

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程.制定决策的整个过程,同时也是进行决策思维的过程.近年来,高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂.如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性具有重要的现实意义.     

关于临床决策问题

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程.制定决策的整个过程,同时也是进行决策思维的过程.近年来高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂.如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性、局限性及惰性具有重要的现实意义.     

《管理决策逻辑》评介

任何一位管理者,总要为实现某种管理目标而制定、实施一定的方案,总要在管理过程中做出一些大大小小的决策,离开一定的决策就不能实现特定的管理目标,也无法进行管理。不论是行政管理、经济管理,还是科技管理、军事管理;也不论是一个班组、车间或部门的管理,还是一个县、一个省乃至整个国家的管理,无不如此。 决策离不开思维。决策的过程,也就是思维的过程。因为决策是要进行新的探索的,从现实推测未来,从已知推断未知,在     

辩证思维在头颈肿瘤诊治过程中的应用

辩证思维贯穿于整个临床诊疗过程中,每位医师在做出临床决策时,均自觉或不自觉地遵循着该原理。在头颈肿瘤的临床实践中,也应始终遵循辩证思维,使哲学思维和科学思维密切结合。合理、正确地运用辩证思维方法有助于深入认识头颈肿瘤疾病的发生、发展及演变过程,从而采取合理、有效的治疗措施。     

跳出思维定势陷阱

正成见和直觉会导致人们做出错误决策。如果能认清这些思维模式,或可避免踏入思维定势的陷阱。锚定偏见:人很容易过于依赖其所接触的最初一部分信息。譬如在谈工资的过程中,最先提出工资金额方案者,会令听者感觉各种条款都合理。     

满意化者比最优化者的决策更具有延展性

<正>生活中我们无时不刻不在面临和进行着大大小小的决策：小到今天要去吃什么，大到一个国家政策的制定。我们会发现，个体差异对决策结果产生不同的作用，像稳定的人格特质和不同的决策风格等，都会在人们做决策的过程中产生影响。那么，我们做出的判断和决策到底会因此而产生怎样的差异呢？基于诺贝尔奖得主西蒙提出的决策满意化原则，舒瓦茨等人在此基础上又提出两种决策风格，     

急性胰腺炎临床决策中的辩证思维观

急性胰腺炎（AP）是临床常见危重症。近年来AP诊断和治疗取得了令人瞩目的进展,及早诊断和恰当、合理的生命支持治疗极大改善了AP患者的预后。临床上AP患者病情往往复杂多变,要求在极短时间内做出正确的临床决策,科学理性的临床决策思维对AP患者的合理诊治起着非常重要的指导作用。临床医师应努力学习和充分灵活地运用辩证思维,为对AP进行科学的临床诊疗决策提供合理的思路。     

《决策过程的思维主线是从抽象到具体》

决策的过程,就是对大量信息进行提炼,认识现状和预测未来、确定目标并选择达到目标的方案韵过程。在决策过程中,思维的起点是问题。问题不是感性存在,它是靠理性思维从大量事实、现象、信息中概括抽象出来的。问题是人们对应有现象和实际现象之间的差距的本质的把握。问题是一个简单的抽象,但同时它又包含着全部决策过程中一切矛盾的萌芽,是全部决策过程赖以发展的基础。通过发现问题,已把实际状态基本调查清楚;为了搞清事物的应有状态,思维便从     

决策过程的追踪:基于眼动的证据

利用过程追踪技术实现对"决策过程"的追踪,或能真正解答"人类是如何做出决策"这一科学问题。在各种过程追踪技术中,眼动技术由于具有无干扰性、适用范围广泛、采集信息多样等独一无二的优势,已被广泛应用于各种决策研究中,为验证和比较不同决策理论的不同假设和预测做出了贡献。本文介绍了眼动技术如何被应用于验证补偿性决策理论与非补偿性决策理论对风险决策过程的不同假设,眼动技术如何用于检验多次决策与单次决策的决策过程差异,以及眼动技术如何用于检验"剔除–关注模型"与"齐当别决策模型"对多属性决策中共享信息发挥作用机制的不同预测。     

还原论对临床决策的影响

“看病贵”已经不仅仅是一个简单的医院职能问题了,从政治、经济、文化、社会、环境、医学、心理等各个领域,都对这个问题展开了广泛的探讨和研究,本文从哲学和医学发展史的角度,纵深剖析了还原论对医院临床决策的影响,指出当前医院的种种弊端在很大程度上是由于受到还原论的思维方式的不利影响,希望能够为临床决策的改进提供一条新的思路。     

诺贝尔生理学或医学奖美国获得者学术条件背景分析

在诺贝尔生理学或医学奖105年的历史中,美国分别占了颁奖年度的52.08%,获奖成果的44.87%,获奖人数的48.91%.形成这些科学家学术优势积累和美国国家科技竞争优势的学术条件背景是:适宜的宏观政策,充足的经费投入,成功的人才政策,根本的教育改革和创新的科技管理.     

羊水栓塞诊断的临床决策

临床决策已成为临床医学的重要内容,但目前仍被许多妇产科医师所忽视。通过阐述临床决策的概念及意义,分析了羊水栓塞诊断中应该注意的问题,探讨了如何建立科学的羊水栓塞诊断的临床决策。为了提高临床决策的效率和准确性,减少或避免各种失误,需要建立一套合理的临床思维方法和科学的处理程序,为羊水栓塞的治疗提供科学的决策方法。     

Development of an Interactive Decision Aid for Female BRCA1/BRCA2 Carriers

Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer.     

临床决策偏差中的心理效应

临床决策是临床工作的核心。科学正确的临床决策是保证医疗服务质量的重要环节。现代心理学对临床决策的研究发现,由于决策双思维系统运转模式的存在,一些心理效应常常会导致临床决策出现系统性偏差或失误,这些心理效应包括易得性、拆分效应、锚定效应、框架效应、单次-重复博弈效应和后见之明效应等。医务人员了解这些心理效应的表现,熟悉它们对临床决策的潜在影响,并在进行重大临床决策时有效避免之,将会显著提升临床决策质量。     

Investigating medical decision‐making capacity in patients with cognitive impairment using a protocol based on linguistic features

A critical question is whether cognitively impaired patients have the competence for autonomous decisions regarding participation in clinical trials. The present study aimed to investigate medical decision‐making capacity by use of a Swedish linguistic instrument for medical decision‐making (LIMD) in hypothetical clinical trials in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Three comparable groups (age, education) participated in the study: AD (n = 20; MMSE: 24.1 ± 3.3) and MCI (n = 22; MMSE: 26.7 ± 2.4) patients and healthy controls (n = 37; MMSE: 29.1 ± 1.0). Medical decision‐making capacity was operationalized as answers to questions regarding participation in three hypothetical clinical trials. Answers were scored regarding comprehension, evaluation and intelligibility of decisions, and a total LIMD score was used as the measure of medical decision‐making ability. Groups differed significantly in LIMD with AD patients performing worst and MCI poorer than the control group. A strong association was found between all LIMD scores and diagnosis which supported the assertion that LIMD as it is designed is a one‐dimensional instrument of medical decision‐making capacity (MDMC). The results indicate that a fundamental communicative ability has an impact on the competence for autonomous decisions in cognitive impairment.     

循证医学与喉癌治疗的临床决策

循证医学(Evidence-based medicine,EBM)的飞速发展正逐渐渗透到基础医学和临床医学的各个领域。目前喉癌治疗的临床决策还存在很多不规范和不合理的问题。这要求用循证医学的原则来指导和规范喉癌治疗的临床决策,以期能在目前条件下提高病人的治疗效果、降低医疗费用及提高生活质量。     

A study of the foundations of ethical decision making of clinical medical ethicists

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values.     

Software development for the nonprogrammer: An instructional clinical example

This paper presents an innovative way to instruct students in logical decision making in a psychology assessment course without their needing to know any programming language. This also yielded a tool that can aid students in making differential diagnoses of psychological as opposed to medical conditions.