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Patient Care under Uncertainty (Hardcover)
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Patient Care under Uncertainty (Hardcover)
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How cutting-edge economics can improve decision-making methods for
doctors Although uncertainty is a common element of patient care,
it has largely been overlooked in research on evidence-based
medicine. Patient Care under Uncertainty strives to correct this
glaring omission. Applying the tools of economics to medical
decision making, Charles Manski shows how uncertainty influences
every stage, from risk analysis to treatment, and how this can be
reasonably confronted. In the language of econometrics, uncertainty
refers to the inadequacy of available evidence and knowledge to
yield accurate information on outcomes. In the context of health
care, a common example is a choice between periodic surveillance or
aggressive treatment of patients at risk for a potential disease,
such as women prone to breast cancer. While these choices make use
of data analysis, Manski demonstrates how statistical imprecision
and identification problems often undermine clinical research and
practice. Reviewing prevailing practices in contemporary medicine,
he discusses the controversy regarding whether clinicians should
adhere to evidence-based guidelines or exercise their own judgment.
He also critiques the wishful extrapolation of research findings
from randomized trials to clinical practice. Exploring ways to make
more sensible judgments with available data, to credibly use
evidence, and to better train clinicians, Manski helps
practitioners and patients face uncertainties honestly. He
concludes by examining patient care from a public health
perspective and the management of uncertainty in drug approvals.
Rigorously interrogating current practices in medicine, Patient
Care under Uncertainty explains why predictability in the field has
been limited and furnishes criteria for more cogent steps forward.
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