Clinicians spend their working lives making decisions. such
decisions are usually made in interlocking streams rather than in
the discrete circumscribed contexts so beloved of scientists. When
the clinician encounters a patient a complex interactive process is
initiated in which the clinician searches his memory to match the
symptoms and signs indicated by the patient with the complex
disease models which he carries in his head. He then makes choices
about further questions or tests in order to clarify his
understanding of the patient's problem and to formulate a
management or treatment plan. In recent years there has been
increasing interest in how clinicians make such decisions and a
realization that decision-making in clinical medicine is virtually
the same as that in many other professional contexts. The
scientific study and formal teaching of clinical decision-making is
a relatively young discipline. Less than 20 books have so far
appeared which take explicit account of the theoretical and
experimental decision-making literature in medicine and other
related disciplines. This book is a distinctive and important
contribution to this growing field. It combines a comprehensive
critical analysis of a wide range of relevant philo sophical,
statistical, psychological and medical literature with an
interesting set of experimental observations of primary care
physicians. Dr. Ridderikhoff shows great erudition and wide command
of a large reference literature. Dr. Ridderikhoff takes a firmly
descriptive rather than prescriptive viewpoint on understanding
clinical decision-making."
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