De Alencastro Lionel, Clair Carole, Locatelli Isabella, Ebell Mark H, Senn Nicolas
Centre de médecine générale, PMU, 1011 Lausanne.
Centre de recherche et développement, PMU, 1011 Lausanne.
Rev Med Suisse. 2017;13(562):986-989.
Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making. Furthermore, the use of tools such as clinical scores has taken an important place with the evidence based medicine. Given the fact that they are partly theoretical, it is necessary to assess whether these recommendations are in line with clinical practice.
能够分析从首次接触患者到最终诊断的所有连续决策步骤是复杂的，因为这有时涉及到每位临床医生特有的直觉因素。然而，了解他们如何将疾病概率整合到临床实践中以及如何处理诊断不确定性至关重要。这有助于更合理地行医，并识别与患者、医生或背景相关的可能改变临床决策的因素。此外，临床评分等工具在循证医学中占据了重要地位。鉴于这些工具部分基于理论，有必要评估这些建议是否与临床实践相符。
