Elstein A S
World J Surg. 1989 May-Jun;13(3):287-91. doi: 10.1007/BF01659036.
Surgical education can no longer be considered adequate if limited to description of surgical diseases and methods of management. Due to the growth in numbers of surgical diagnostic and therapeutic procedures, the surgeon of the future will find it increasingly necessary to understand the principles by which algorithms are constructed and by which individualized decisions should be made. Several systematic approaches for assisting clinical decision makers have been developed. Decision analysis is particularly appealing because it is flexible and readily adapted to a wide range of clinical situations. It explicitly guides the decision maker in determining the crucial variables in a clinical decision, and permits both objective data and personal preferences to play a part in decision making. Because it provides for personal estimates and preferences, decision analysis is not dehumanizing, even though it is quantitative, explicit, and mathematically rigorous. Topics for a series of seminars or case conferences are suggested. Decision analysis should be part of the intellectual preparation of every clinician.
如果外科教育仅限于对外科疾病及其治疗方法的描述，那么它就不能再被认为是足够的了。由于外科诊断和治疗程序数量的增加，未来的外科医生将越来越有必要理解构建算法以及做出个性化决策所依据的原则。已经开发出了几种协助临床决策者的系统方法。决策分析特别有吸引力，因为它灵活且易于适用于广泛的临床情况。它明确地指导决策者确定临床决策中的关键变量，并允许客观数据和个人偏好都在决策中发挥作用。由于它考虑了个人估计和偏好，决策分析即使是定量的、明确的且在数学上很严谨，也不会使决策失去人性化。文中还提出了一系列研讨会或病例讨论会的主题。决策分析应该成为每位临床医生知识储备的一部分。
