Lecture 1 Recognising and capturing clinical ncertainty讲座1识别和捕获的临床的不确定性.ppt

下载文档 降价啦

3
0
约7.35千字
约 26页
2018-06-19 发布于福建
举报
版权申诉
保障服务

Lecture 1 Recognising and capturing clinical ncertainty讲座1识别和捕获的临床的不确定性.ppt

1、本文档共26页，可阅读全部内容。
2、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。
3、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。

Lecture 1 Recognising and capturing clinical ncertainty讲座1识别和捕获的临床的不确定性

Dr Carl Thompson, University of York Lecture 1Recognising and capturing clinical uncertainty Foreground and background knowledge clarification Clinical uncertainty Clinical judgement Clinical decision making Evidence based decision making Clinical uncertainty Not certainly knowing or known Sources Defining a disease Making a diagnosis Selecting an intervention Observing outcomes Assessing patient preferences Combing information in a decision Quantifying Uncertainty True state of the patient cannot be directly observed Clinician must use imperfect external cues Probability as a language for expressing uncertainty Probability Fundamentals Strength of belief A number between 0 and1 that expresses an opinion about the likelihood of an event Probability of an event that is certain to occur is 1 Probability of an event that is certain to NOT occur is 0 Types of probability Components of Probability Estimates Personal experience Published experience - evidence Attributes of the patient Clinical decision and judgement Clinical judgement Assessment of alternatives Clinical decision Choosing between alternatives (Dowie 1988) The decisions clinicians make. Diagnosis and test ordering (Dx) Treatment (Rx) Targeting Timing referral Communicating (risks and benefit info) Seeking more information S.D.O. (service delivery and organisation) Clinical uncertainty – the good news Aeschylus – ‘hope comes from the lack of certainty of fate’ Complete certainty = lack of hope Examination results predicted life success (100% accurately) Learning at age 12 that you possess the Alzheimer’s gene Adaptation to Huntington’s and HIV status Asking questions Background questions: General knowledge about a disorder A root (who, what, when, how, and why) a verb A disorder or aspect of a disorder E.g. ‘what causes angina?’ Foreground questions P.I.C.O. Specific knowledge about management of people with a disorder Population: the people who are on the receiving end of your judge