Medical

Decision Making in Health and Medicine

Integrating Evidence and Values

Author: M. G. Myriam Hunink,Milton C. Weinstein,Eve Wittenberg,Michael F. Drummond,Joseph S. Pliskin,John B. Wong,Paul P. Glasziou

Publisher: Cambridge University Press

ISBN: 1316062317

Category: Medical

Page: N.A

View: 455

Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing the resources required. This text takes a proactive, systematic and rational approach to medical decision making. It covers decision trees, Bayesian revision, receiver operating characteristic curves, and cost-effectiveness analysis, as well as advanced topics such as Markov models, microsimulation, probabilistic sensitivity analysis and value of information analysis. It provides an essential resource for trainees and researchers involved in medical decision modelling, evidence-based medicine, clinical epidemiology, comparative effectiveness, public health, health economics, and health technology assessment.
Medical

Cost-Effectiveness in Health and Medicine

Author: Marthe R. Gold,Joanna E. Siegel,Louise B. Russell,Milton C. Weinstein

Publisher: Oxford University Press

ISBN: 0199880425

Category: Medical

Page: 456

View: 5857

A unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEAs) as decision-making aids in the health and medical fields, this volume is the product of over two years of comprehensive research and deliberation by a multi-disciplinary panel of economists, ethicists, psychometricians, and clinicians. Exploring cost-effectiveness in the context of societal decision-making for resource allocation purposes, this volume proposes that analysts include a "reference-case" analysis in all CEAs designed to inform resource allocation and puts forth the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, evaluating outcomes, discounting, and dealing with uncertainty are examined in separate chapters. Additional chapters on framing and reporting of CEAs elucidate the purpose of the analysis and the effective communication of its findings. Cost-Effectiveness in Health and Medicine differs from the available literature in several key aspects. Most importantly, it represents a consensus on standard methods--a feature integral to a CEA, whose principal goal is to permit comparisons of the costs and health outcomes of alternative ways of improving health. The detailed level at which the discussion is offered is another major distinction of this book, since guidelines in journal literature and in CEA-related books tend to be rather general--to the extent that the analyst is left with little guidance on specific matters. The focused overview of the theoretical background underlying areas of controversy and of methodological alternatives, and, finally, the accessible writing style make this volume a top choice on the reading lists of analysts in medicine and public health who wish to improve practice and comparability of CEAs. The book will also appeal to decision-makers in government, managed care, and industry who wish to consider the uses and limitations of CEAs.
Medical

Medical Decision Making

Author: Harold C. Sox,Michael C. Higgins,Douglas K. Owens

Publisher: John Wiley & Sons

ISBN: 1118341562

Category: Medical

Page: 368

View: 1804

This book clearly demonstrates how to best make medical decisions while incorporating clinical practice guidelines and decision support systems for electronic medical record systems. New to this edition is how medical decision making ideas are being incorporated into clinical decision support systems in electronic medical records and also how they are being used to shape practice guidelines and policies.
Medical

Medical Decision Making

A Physician's Guide

Author: Alan Schwartz,George Bergus

Publisher: Cambridge University Press

ISBN: 9781107320062

Category: Medical

Page: N.A

View: 5417

Decision making is a key activity, perhaps the most important activity, in the practice of healthcare. Although physicians acquire a great deal of knowledge and specialised skills during their training and through their practice, it is in the exercise of clinical judgement and its application to individual patients that the outstanding physician is distinguished. This has become even more relevant as patients become increasingly welcomed as partners in a shared decision making process. This book translates the research and theory from the science of decision making into clinically useful tools and principles that can be applied by clinicians in the field. It considers issues of patient goals, uncertainty, judgement, choice, development of new information, and family and social concerns in healthcare. It helps to demystify decision theory by emphasizing concepts and clinical cases over mathematics and computation.
Medical

Rational Diagnosis and Treatment

Evidence-Based Clinical Decision-Making

Author: Peter Gøtzsche

Publisher: John Wiley & Sons

ISBN: 9780470723685

Category: Medical

Page: 244

View: 5216

Now in its fourth edition, Rational Diagnosis and Treatment: Evidence-Based Clinical Decision-Making is a unique book to look at evidence-based medicine and the difficulty of applying evidence from group studies to individual patients. The book analyses the successive stages of the decision process and deals with topics such as the examination of the patient, the reliability of clinical data, the logic of diagnosis, the fallacies of uncontrolled therapeutic experience and the need for randomised clinical trials and meta-analyses. It is the main theme of the book that, whenever possible, clinical decisions must be based on the evidence from clinical research, but the authors also explain the pitfalls of such research and the problems involved in applying evidence from groups of patients to the individual patient. For this new edition, the sections on placebo and meta-analysis and on alternative medicine have been thoroughly updated, and there is more focus on insufficient reporting of harms of interventions. The sections on different research designs describe advantages and limitations, and the increased medicalisation and the effects of cancer screening on health people are noted. A section on academic freedom when clinicians collaborate with industry and ghost authors is added. This essential reference work integrates the science and statistical approach of evidence-based medicine with the art and humanism of medical practice; distinguishing between data, sets of data, knowledge and wisdom, and their application. Such an intellectually challenging book is ideal for both medical students and doctors who require theoretical and practical clinical skills to help ensure that they apply theory in practice.
Psychology

Blackwell Handbook of Judgment and Decision Making

Author: Derek J. Koehler,Nigel Harvey

Publisher: John Wiley & Sons

ISBN: 0470752912

Category: Psychology

Page: 680

View: 6808

The Blackwell Handbook of Judgment and Decision Making is a state-of-the art overview of current topics and research in the study of how people make evaluations, draw inferences, and make decisions under conditions of uncertainty and conflict. Contains contributions by experts from various disciplines that reflect current trends and controversies on judgment and decision making. Provides a glimpse at the many approaches that have been taken in the study of judgment and decision making and portrays the major findings in the field. Presents examinations of the broader roles of social, emotional, and cultural influences on decision making. Explores applications of judgment and decision making research to important problems in a variety of professional contexts, including finance, accounting, medicine, public policy, and the law.
Medical

Essential Evidence-Based Medicine

Author: Dan Mayer

Publisher: Cambridge University Press

ISBN: 9780521540278

Category: Medical

Page: 381

View: 1013

Although using the results of the best research to determine the best care for an individual patient may appear very simple, most medical students and physicians do not have the mathematical background or training to critically evaluate published research. This "user's guide" helps the medical professional to become a more discriminating reader of medical literature, and ultimately better equipped to apply evidence-based medicine in practice. The volume will be an ideal introductory text for medical students and health-care professionals.
Medical

Developmental-Behavioral Pediatrics: Evidence and Practice

Author: Mark Lee Wolraich,Paul Howard Dworkin,Dennis D. Drotar,Ellen C. Perrin

Publisher: Elsevier Health Sciences

ISBN: 0323070701

Category: Medical

Page: 1008

View: 3958

Based on the Diagnostic and Statistical Manual for Primary Care: Child and Adolescent Version (DSM-PC), this state-of-the-art reference expertly guides you through normal and abnormal development and behavior for all pediatric age groups. See how neurobiological, environmental, and human relationship factors all contribute to developmental and behavioral disorders and know how to best diagnose and treat each patient you see. Accurately identify developmental and behavioral problems using the Diagnostic and Statistical Manual for Primary Care criteria, and evidence-based guidelines. Gain a clear understanding of the "normal" boundaries and variations within specific disorders. Make informed therapeutic decisions with the integration of basic science and practical information and recommendations from the Society of Developmental and Behavioral Pediatrics and the American Academy of Pediatrics. Avoid legal and ethical implications by consulting the Law, Policy, and Ethics chapter.
Medical

Cost-Effectiveness Analysis in Health

A Practical Approach

Author: Peter Muennig,Mark Bounthavong

Publisher: John Wiley & Sons

ISBN: 1119011280

Category: Medical

Page: 480

View: 4995

The field's bestselling reference, updated with the latest tools, data, techniques, and the latest recommendations from the Second Panel on Cost-Effectiveness in Health and Medicine Cost-Effectiveness Analysis in Health is a practical introduction to the tools, methods, and procedures used worldwide to perform cost-effective research. Covering every aspect of a complete cost-effectiveness analysis, this book shows you how to find which data you need, where to find it, how to analyze it, and how to prepare a high-quality report for publication. Designed for the classroom or the individual learner, the material is presented in simple and accessible language for those who lack a biostatistics or epidemiology background, and each chapter includes real-world examples and "tips and tricks" that highlight key information. Exercises throughout allow you to test your understanding with practical application, and the companion website features downloadable data sets for students, as well as lecture slides and a test bank for instructors. This new third edition contains new discussion on meta-analysis and advanced modeling techniques, a long worked example using visual modeling software TreeAge Pro, and updated recommendations from the U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. This is the second printing of the 3rd Edition, which has been corrected and revised for 2018 to reflect the latest standards and methods. Cost-effectiveness analysis is used to evaluate medical interventions worldwide, in both developed and developing countries. This book provides process-specific instruction in a concise, structured format to give you a robust working knowledge of common methods and techniques. Develop a thoroughly fleshed-out research project Work accurately with costs, probabilities, and models Calculate life expectancy and quality-adjusted life years Prepare your study and your data for publication Comprehensive analysis skills are essential for students seeking careers in public health, medicine, biomedical research, health economics, health policy, and more. Cost-Effectiveness Analysis in Health walks you through the process from a real-world perspective to help you build a skillset that's immediately applicable in the field.
Business & Economics

Ensuring Value for Money in Health Care

The Role of Health Technology Assessment in the European Union

Author: Corinna Sorenson,Michael Drummond,Panos Kanavos

Publisher: WHO Regional Office Europe

ISBN: 9289071834

Category: Business & Economics

Page: 156

View: 5214

This report addresses the concepts and controversy surrounding health technology assessment in Europe, with a particular focus on selected Member States including Sweden, the Netherlands, Finland, France, Germany and the United Kingdom. It is intended to identify and address current considerations regarding HTA methodological and process issues related to the prioritization and financing of modern health care. In particular, it describes the processes and challenges for identifying and prioritizing assessments; assesses and compares current assessment methods and procedures; and highlights the barriers to effective implementation. The report also ascertains the roles and terms of engagement of key stakeholders, and captures the opportunities and challenges for the use of HTA guidance in general priority-setting, decision-making and health-care provision.
Medical

Evidence-Based Practice in Primary Care

Author: Christopher Silagy,Andrew Haines

Publisher: BMJ Books

ISBN: 9780727915689

Category: Medical

Page: 220

View: 1397

Evidence Based Practice in Primary Health Care is split into two sections. The frist discusses how the individual can apply evidence based medicine in the clinical setting, and the second covers the wider issue of changes in organisation and strategy to promote better and more effective delivery of care within a practice or primary care group. Chapters are writtten by leading specialists in evidence based primary care from Australlia, the UK,and mainland Europe.
Medical care

Methods for the Economic Evaluation of Health Care Programmes

Author: Michael F. Drummond,Mark J. Sculpher,Karl Claxton,Greg L. Stoddart,George W. Torrance

Publisher: Oxford University Press

ISBN: 0199665877

Category: Medical care

Page: 464

View: 9593

The purpose of economic evaluation is to inform decisions intended to improve healthcare. The new edition of Methods for the Economic Evaluation of Health Care Programmes equips the reader with the essential hands-on experience required to undertake evaluations by providing a 'tool kit' based on the authors' own experiences of undertaking economic evaluations. Building on the strength of the previous edition, the accessible writing style ensures the text is key reading for the non-expert reader, as no prior knowledge of economics is required. The book employs a critical appraisal framework, which is useful both to researchers conducting studies and to decision-makers assessing them. Practical examples are provided throughout to aid learning and understanding. The book analyses the methodological and policy challenges that face health systems in seeking to allocate resources efficiently and fairly. New chapters include 'Principles of economic evaluation' and 'Making decisions in healthcare' which introduces the reader to core issues and questions about allocation, and provides an understanding of the fundamental principles which guide decision making. A key part of evidence-based decision making is the analysis of all the relevant evidence to make informed decisions and policy. The new chapter 'Identifying, synthesising and analysing evidence' highlights the importance of systematic review, and how and why these methods are used. As methods of analysis continue to change the chapter on 'Characterising, reporting and interpreting uncertainty' introduces the reader to recent methods of analysis and why uncertainty matters for health care decision. The fourth edition of Methods for the Economic Evaluation of Health Care Programmes has been thoroughly revised and updated, making it essential reading for anyone commissioning, undertaking, or using economic evaluations in health care, including health service professionals, health economists, and health care decision makers.
Business & Economics

Value Management in Healthcare

How to Establish a Value Management Office to Support Value-Based Outcomes in Healthcare

Author: Nathan William Tierney

Publisher: Taylor & Francis

ISBN: 1351591487

Category: Business & Economics

Page: 337

View: 717

Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Mr. Porter, accompanied by his esteemed Harvard colleague, Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Mr. Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.
Medical

Crossing the Quality Chasm:

A New Health System for the 21st Century

Author: Committee on Quality of Health Care in America,Institute of Medicine

Publisher: National Academies Press

ISBN: 0309072808

Category: Medical

Page: 360

View: 8890

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Medical

Libraries without Limits: Changing Needs — Changing Roles

Proceedings of the 6th European Conference of Medical and Health Libraries, Utrecht, 22–27 June 1998

Author: Suzanne Bakker

Publisher: Springer Science & Business Media

ISBN: 9401146217

Category: Medical

Page: 305

View: 2164

Proceedings of the 6th European Conference of Medical and Health Libraries, Utrecht, 22-27 June 1998
Medical

Evidence-based Practice in Nursing & Healthcare

A Guide to Best Practice

Author: Bernadette Mazurek Melnyk,Ellen Fineout-Overholt

Publisher: Lippincott Williams & Wilkins

ISBN: 1605477788

Category: Medical

Page: 599

View: 1040

Bernadette Mazurek Melnyk and Ellen Fineout-Overholt are creators of the ARCC (Advancing Research and Clinical practice through close Collaboration) Model, an innovative strategy for implementing and sustaining evidence-based practice in healthcare systems. The ARCC Model is cited as an exemplar of education in evidence-based practice in the Board on Health Care Services and the Institute of Medicine's book, Health Professions Education: A Bridge to Quality. "McInyk and Fineout-Overholt's book should be required reading in all graduate programs. Their text has provided a blueprint for the future of nursing practice and a rigorously substantiated and clearly described means for clinicians, educators, and administrators to participate in improving quality of care." Janet D. Allan, PhD, RN, FAAN Dean and Professor University of Maryland School of Nursing "Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice has been instrumental in developing a culture of evidence-based practice at Barnes-Jewish Hospital. It is fundamental to our curriculum provided to all levels of staff, from new graduate nurses to the highest levels of hospital leadership." Dr. Patricia Potter, RN, PhD, FAAN, Dr. Gail Rea, RN, PhD, CNE, Dr. Karen Balakas, RN, PhD, CNE, Jennifer Williams, MSN, RN, ACNS-BC, Elizabeth Pratt, MSN, RN, ACNS-BC Evidence Equals Excellence group at Barnes-Jewish Hospital and Barnes-Jewish School of Nursing at Goldfarb Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice is an exemplary text that spans the continuum of nursing evidence to support best practice. Utilizing this text with undergraduate, RN to BSN, and graduate nursing students, it is the ONLY text that demonstrates how to retrieve, read, and analyze evidence whether it is published as an individual study, systematic review, meta-analysis, best practice guideline, or outcomes management report. Students learn how to utilize multiple complex databases and websites as they move through each chapter. And, they experience dissemination of evidence through the development of presentations, publications, posters, and grants. This is truly a remarkable book that embraces evidence as the basis for nursing practice and patient-centered care and safety. Having used this text with more than 1000 students over the past five years, I can honestly say that I have found no other text that facilitates learning and development of clinical judgment that is grounded in valid, reliable, and applicable evidence. This is a keeper! Alice E. Dupler, JD, APRN-BC Clinical Associate Professor Washington State University College of Nursing "I have used the book since I developed the Evidence-based Practice course for our College of Nursing in Fall 2007. It was the first course of its kind at Indiana State University. It has been well received and the preferred course for all nursing graduate students for completion of their final scholarly projects. The text was essential in developing the course and provides the foundation and guidance that the students need to develop their Evidence Based Practice projects...the students love the text!" Susan Eley PhD, RN, FNP-BC Assistant Professor Director FNP Program Indiana State University
Science

Genomic and Precision Medicine

Foundations, Translation, and Implementation

Author: Geoffrey S. Ginsburg,Huntington F Willard

Publisher: Academic Press

ISBN: 0128006560

Category: Science

Page: 398

View: 7858

Genomic and Precision Medicine: Translation and Implementation highlights the various points along the continuum from health to disease where genomic information is impacting clinical decision-making and leading to more personalization of health care. The book pinpoints the challenges, barriers, and solutions that have been, or are being, brought forward to enable translation of genome based technologies into health care. A variety of infrastructure (data systems and EMRs), policy (regulatory, reimbursement, privacy), and research (comparative effectiveness research, learning health system approaches) strategies are also discussed. Readers will find this volume to be an invaluable resource for the translational genomics and implementation science that is required to fully realize personalized health care. Provides a comprehensive volume on the translation and implementation of biology into health care provision Presents succinct commentary and key learning points that will assist readers with their local needs for translation and implementation Includes an up-to-date overview on major ‘translational events’ in genomic and personalized medicine, along with lessons learned