Description
"Although uncertainty is common in patient care, it has not been largely addressed in research on evidence-based medicine. Patient Care Under Uncertainty strives to correct this huge omission. For the past few years, renowned economist Charles Manski hasbeen applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. In the precise language of econometrics, "uncertainty" means that the available evidence and knowledge do not suffice to yield precise probabilistic predictions. In the health-care sphere, the most common example is a choice between periodic surveillance or aggressive treatment of patients at risk of a potential disease. Manski examines the subject by applying the economic principals of personalized risk assessment to research on treatment response. Through his work as an econometrician, Manski shows how statistical imprecision and identification problems affect empirical research in the patient care sphere. In the book, Manski reviews continuing discourse in medicine and critiques how evidence from randomized clinical trials has been used to inform decision making. He describes research on identification, develops decision-theoretic principles for reasonable care under uncertainty, and offers suggestions for sensible decision-making with sample data from randomized trials. Manski ends by reviewing patient care from a public-health perspective and considering management of uncertainty in drug approval. In terms of patient care, Manski seeks to help clinicians, public health planners, and patients recognize and cope with uncertainty when making decisions about patient care"--Provided by publisher.
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How cutting-edge economics can improve decision-making methods for doctorsAlthough 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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