Sisson J C, Schoomaker E B, Ross J C
JAMA. 1976 Sep 13;236(11):1259-63. doi: 10.1001/jama.236.11.1259.
Acquisition of laboratory data bearing on a clinical problem may make patient care worse rather than better. The hazards of obtaining new information, that go beyond the monetary costs and risks to physical well-being, are frequently not appreciated by physicians. In the complex and many-faceted practice of medicine, intuition, even when expressed by experienced clinicians, may lead to faulty judgments. Decision analysis gives a systematic exposition of clinical management, and lessens, if not eliminates, the influence of biased and unreliable intuition. With practice, most physicians could employ decision analysis to help solve moderately complicated problems at the bedside or in the office. Use of this tactic will make gaps in knowledge explicit, and may thereby stimulate investigations to ensure better clinical judgments in the future.
获取与临床问题相关的实验室数据可能会使患者护理情况变差而非变好。获取新信息的危害,超出了金钱成本和对身体健康的风险,医生们常常并未意识到这一点。在复杂且多方面的医学实践中,即便由经验丰富的临床医生表达出来,直觉也可能导致错误的判断。决策分析对临床管理进行了系统阐述,即便不能消除,也会减少有偏差且不可靠的直觉的影响。通过实践,大多数医生可以运用决策分析来帮助解决床边或办公室里中度复杂的问题。使用这种策略将使知识差距变得明显,从而可能会激发调查研究,以确保未来能做出更好的临床判断。