Medical Decision Making-Geisel School of Medicine at Dartmouth, Hanover, NH, USA

Textbook:Medical Decision Making, 3rd Edition
Author(s): Harold C. Sox

Description:
Chapters 1 and 2 set the stage: uncertainty is everywhere in clinical practice, yet clinical reasoning depends on logical deduction as exemplified by differential diagnosis. Chapters 3, 4, and 5 are about defining and navigating uncertainty: determining probability, updating probability, and the determinants of post-test probability, all basic tools of the clinician. Chapters 6 and 7 are about modeling the factors that shape decisions. Chapters 8-12 explore in-depth the measurement of utility, both the basics and the underlying theory. Topics include attitudes toward taking risks, the quality of life, and the length of life. The last three chapters are about making deci-
sions: deciding when to treat, when to test, and when to wait (Chapter 13); the advanced modeling methods that inform policy (Chapter 14); and cost-effectiveness analysis (Chapter 15).
This coursebook describes how to translate subjective judgements about events into numbers-probabilities and utilities-
with which to identify the best decision— treat, test, or do nothing— for an individual. While the book uses a numerical framework to guide decision making, the actual math is straightforward except for parts of Chapters 8-12. Even there, the text surrounding the math will explain the basic concepts. Bottom line: when the reader finds the math challenging, read on. The text will explain what it means.