Projective expected utility

Motivated by several classic decision-theoretic paradoxes, and by analogies with the paradoxes which in physics motivated the development of quantum mechanics, we introduce a projective generalization of expected utility along the lines of the quantum-mechanical generalization of probability theory. The resulting decision theory accommodates the dominant paradoxes, while retaining significant simplicity and tractability. In particular, every finite game within this larger class of preferences still has an equilibrium.     

一期前后联合入路治疗上颈椎畸形

回顾9例因颅底凹陷症合并其它畸形在我科接受一期经口咽齿状突切除、后路枕骨大孔减压、寰枢椎或枕颈融合术治疗的,临床资料,观察该术式对脊髓功能、枕颈部稳定性的影响及其临床疗效。本组术前诊断均为颅底凹陷症合并邻近结构畸形。所有患者均接受前后联合入路手术。末次随访JOA评分15±1分。影像学检查示齿状突残留基底部均位于钱氏线以下,脊髓减压充分,寰枢间、枕颈间植骨均获坚强融合,融合时间平均3．9±1.1个月。因此一期前后路联合手术治疗颅底凹陷症,脊髓减压充分,重建稳定性后骨融合好,治疗效果满意。     

Decomposition,Interdependence and Precision in Multiattribute Utility Measurements

Traditionally, parameters of multiattribute utility models, representing a decision maker's preference judgements, are treated deterministically. This may be unrealistic, because assessment of such parameters is potentially fraught with imprecisions and errors. We thus treat such parameters as stochastic and investigate how their associated imprecision/errors are propagated in an additive multiattribute utility function in terms of the aggregate variance. Both a no information and a rank order case regarding the attribute weights are considered, assuming a uniform distribution over the feasible region of attribute weights constrained by the respective information assumption. In general, as the number of attributes increases, the variance of the aggregate utility in both cases decreases and approaches the same limit, which depends only on the variances as well as the correlations among the single-attribute utilities. However, the marginal change in aggregate utility variance decreases rather rapidly and hence decomposition as a variance reduction mechanism is generally useful but becomes relatively ineffective if the number of attributes exceed about 10. Moreover, it was found that utilities which are positively correlated increase the aggregate utility variance, hence every effort should be made to avoid positive correlations between the single-attribute utilities. We also provide guidelines for determining under what condition and to what extent a decision maker should decompose to obtain an aggregate utility variance that is smaller than that of holistic assessments. Extensions of the current model and empirical research to support some of our behavioural assumptions are discussed. © 1997 John Wiley & Sons, Ltd.     

Building and Maintaining Clinical Programs

This paper describes the basic elements of practice development and management within the academic medical setting. These include assessment of the market environment, both in the community and within the medical setting, product development, marketing, budget basics, quality, managed care negotiations, and finding time to do research in a financially-driven health care system.     

现代姑息医学内涵在实践中的演化

积极开展姑息医学服务已成肿瘤临床工作者的共同实践,并使其在实践中得到发展。姑息医学在肿瘤整体治疗中的作用和地位已逐渐受到同行的认同,提高了肿瘤工作者对姑息医学实践的参与热情,使业内有识之士从全新的角度对姑息医学的内涵进行审视。本文拟结合姑息医学的发展历程及不同分期肿瘤患者姑息治疗的内容介绍现代姑息医学内涵的演化过程。     

肝癌基础研究如何向临床转化

肝癌基础研究在过去数十年取得了长足的进步,而肝癌临床研究则相对滞后,二者间存在巨大的反差。如何将基因组时代发现的大量有重要意义的基础研究成果及时有效地转化为临床可用的技术方法,以进一步提高肝癌治疗效果是亟待解决的难题。转化医学研究为其搭建了一条重要桥梁。     

转化医学与肿瘤诊治

转化医学是促进基础研究成果向临床应用转化和根据临床医学的需求从事应用基础研究的桥梁。本文以转化医学在肿瘤防治研究的实例,分析转化医学的意义,以期为使大家重视转化医学,提高肿瘤诊治水平。     

A simple trade-off condition for additive multiattribute utility

We show that only two simple trade-off judgments are sufficient to determine whether the multiplicative multiattribute model assumes its additive form, regardless of the number of attributes in the model. This additivity condition offers a useful alternative to the test based on multiattribute lotteries commonly presented in textbooks. It can make the determination of additivity easier and more reliable. © 1997 John Wiley & Sons, Ltd.     

我国转化医学发展现状的思考

转化医学在当今世界发展迅速,虽然在我国起步较晚,但取得了巨大的成就,建立了许多转化医学研究机构,积极开展合作交流,但不可避免地存在一些问题,诸如创新能力不足、顶层设计不够和人才缺乏等,为此提出相应对策和未来发展的前景,同时指出转化医学在我国不仅是学术问题,而且是社会问题.     

医学生临床实习应掌握的几种哲学思维方式

为适应全球卫生事业的迅猛发展,面对医学教育落后于医学发展的现状,转化医学教育迫在眉睫。在第三代“以系统为基础”的教育改革中,培养医学生的哲学思维无疑是其重要环节之一。思维方式必须在医学生步入临床时就要开始正确培养,一旦开始阶段就养成不正确的思维方式、不但会导致医疗过程中的失误,而且再想改变将会有很大难度。本文通过对医学哲学重要性的探讨,剖析医学生哲学思维的不足,阐述了医学生,临床实习过程中应掌握的几种哲学思维方式。旨在提高医学生的哲学理念,促进以岗位胜任能力为导向的医学教育转型发展。