Gifford D R, Mittman B S, Vickrey B G
Division of General Internal Medicine and Health Services Research, University of California Los Angeles, USA.
Neurol Clin. 1996 Feb;14(1):223-38. doi: 10.1016/s0733-8619(05)70251-6.
Studies examining physicians' clinical decisions have demonstrated considerable variation in decisions and practices and identified numerous challenges to effective, efficient, and accurate decision making. Although use of the decision aids and tools described in this article may help overcome many of these challenges, greater self-awareness of the diagnostic reasoning process and the factors influencing decisions also should help improve clinical decisions and reduce variation, irrespective of the use of these tools. Continued research into the determinants and nature of the diagnostic reasoning process will provide additional insights that can be used to develop and apply improved decision aids and corrective procedures to overcome persistent problems.
对医生临床决策的研究表明,决策和实践存在相当大的差异,并发现了有效、高效和准确决策面临的众多挑战。尽管使用本文所述的决策辅助工具可能有助于克服其中许多挑战,但提高对诊断推理过程以及影响决策的因素的自我认知,无论是否使用这些工具,也都应有助于改善临床决策并减少差异。对诊断推理过程的决定因素和性质的持续研究将提供更多见解,可用于开发和应用改进的决策辅助工具及纠正程序,以克服长期存在的问题。