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Author : Paul K. J. Han Publisher : Oxford University Press Page : 193 pages File Size : 48,8 Mb Release : 2021 Category : Medical ISBN : 9780190270582
Introduction : The Challenge of Uncertainty in Medicine -- The Nature and Etiology of Uncertainty -- The Anatomy of Uncertainty -- The Natural History of Uncertainty -- The Management of Uncertainty -- A Way Forward : Systematizing Uncertainty Tolerance.
Author : Avril Danczak,Alison Lea,Geraldine Murphy Publisher : Royal College of General Practitioners Page : 342 pages File Size : 43,6 Mb Release : 2016-02-28 Category : Medical ISBN : 9780850844184
Mapping Uncertainty in Medicne by Avril Danczak,Alison Lea,Geraldine Murphy Pdf
Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians, who fear they will make shameful or guilt inducing errors. This book offers a succinct method to clinicians for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully. Every clinician experiences moments when 'they don't know what to do'. Modern medicine is increasingly complex and training has also become more complicated. The days of 'see one, do one, teach one' are over. Yet, both younger clinicians and senior practitioners describe uncertainty as one of the most challenging and stressful aspects of clinical work. If uncertainty is uncomfortable or threatening to individual practitioners, it also provides complex educational challenges. How can we learn to cope with uncertainty effectively ourselves? How can we teach others to understand and manage uncertainty? In this ground breaking book, the authors propose ways to cut through uncertainty, which is explored as an inevitable (and even desirable) component of clinical practice. A Map of Uncertainty in Medicine (MUM) is used to classify uncertainty and to define the skills that will help find a way though practical difficulties. It is always good to have your MUM with you in a tricky situation!
The Good Doctor by Kenneth Brigham,Michael M. E. Johns Pdf
What makes a good doctor? It's not what you think. A doctor willing to face their own uncertainty in the face of illness and treatment might just be the best medicine. Too often we choose the wrong doctor for the wrong reasons. It doesn't have to be that way. In The Good Doctor, Ken Brigham, MD, and Michael M.E. Johns, MD, argue that we need to change the way we think about health care if we want to be the healthiest we can be. Counterintuitive as it may seem, uncertainty is integral to medicine, and you want a doctor who knows that: someone who sees you as the unique case you are, someone who knows that data isn't everything, someone who is able to change her mind as the information changes. For too long we've clung to the myth of the infallible doctor--one who assuredly tells us this is what's wrong and here is how I will cure you--and our health has suffered for it. Brigham and Johns propose a new model of medicine, one that is comfortable with ambiguity and that centers on an equal partnership between patient and doctor. Uncertainty, properly embraced, opens a new universe of possibilities.
Uncertainty in Medical Innovation by Jessica Mesman Pdf
The Neonatal Intensive Care Unit is a site where hi-tech medicine and vulnerable human beings come into close contact. Focusing on a number of medical and ethical challenges encountered by staff and parents, this book provides a new perspective on the complexity of these treatments and the inventiveness of those involved.
Patient Care Under Uncertainty by Charles F. Manski Pdf
For the past few years, the author, a renowned economist, has been applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. He shows how statistical imprecision and identification problems affect empirical research in the patient-care sphere.
Testing Treatments by Imogen Evans,Hazel Thornton,Iain Chalmers,Paul Glasziou Pdf
This work provides a thought-provoking account of how medical treatments can be tested with unbiased or 'fair' trials and explains how patients can work with doctors to achieve this vital goal. It spans the gamut of therapy from mastectomy to thalidomide and explores a vast range of case studies.
Author : Robert Aronowitz Publisher : University of Chicago Press Page : 285 pages File Size : 43,8 Mb Release : 2015-09-16 Category : Medical ISBN : 9780226049717
"Will ever-more sensitive screening tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always, says Robert Aronowitz. In fact, it often is hurting us... Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz demonstrates that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty." -- Taken from book flyleaf.
Clinical Uncertainty in Primary Care by Lucia Siegel Sommers,John Launer Pdf
The Power of Colleagues What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients? .....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient? .....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations? .....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice? .....And where they are expected to practice coordinated, evidence-based, EMR-directed care These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone. From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and they present a cogent case for its special relationship to primary care practice...‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.
Doctors, scientists, and patients have long grappled with the dubious nature of “certainty” in medical practice. To help navigate the chaos caused by ongoing bodily change we rely on scientific reductions and deductions. We take what we know now and make best guesses about what will be. But bodies in flux always outpace the human gaze. Particularly in cancer care, processes deep within our bodies are at work long before we even know where to look. In the face of constant biological and technological change, how do medical professionals ultimately make decisions about care? Bodies in Flux explores the inventive ways humans and nonhumans work together to manufacture medical evidence. Each chapter draws on rhetorical theory to investigate a specific scientific method for negotiating medical uncertainty in cancer care, including evidential visualization, assessment, synthesis, and computation. Case studies unveil how doctors rely on visuals when deliberating about a patient’s treatment options, how members of the FDA use inferential statistics to predict a drug’s effectiveness, how researchers synthesize hundreds of clinical trials into a single evidence-based recommendation, and how genetic testing companies compute and commoditize human health. Teston concludes by advocating for an ethic of care that pushes back against the fetishization of certainty—an ethic of care that honors human fragility and bodily flux.
There’s a running joke among radiologists: finding a tumor in a mammogram is akin to finding a snowball in a blizzard. A bit of medical gallows humor, this simile illustrates the difficulties of finding signals (the snowball) against a background of noise (the blizzard). Doctors are faced with similar difficulties every day when sifting through piles of data from blood tests to X-rays to endless lists of patient symptoms. Diagnoses are often just educated guesses, and prognoses less certain still. There is a significant amount of uncertainty in the daily practice of medicine, resulting in confusion and potentially deadly complications. Dr. Steven Hatch argues that instead of ignoring this uncertainty, we should embrace it. By digging deeply into a number of rancorous controversies, from breast cancer screening to blood pressure management, Hatch shows us how medicine can fail—sometimes spectacularly—when patients and doctors alike place too much faith in modern medical technology. The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician’s enthusiasm when unnecessary tests or treatments are being offered. Both humbling and empowering, Snowball in a Blizzard lays bare the inescapable murkiness that permeates the theory and practice of modern medicine. Essential reading for physicians and patients alike, this book shows how, by recognizing rather than denying that uncertainty, we can all make better health decisions.
A brilliant and courageous doctor reveals, in gripping accounts of true cases, the power and limits of modern medicine. Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human. Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives. At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor. Complications is a 2002 National Book Award Finalist for Nonfiction.
Set against the unexplained stroke of the author’s newborn daughter, this stunning, unflinchingly honest memoir is a thought-provoking reflection on uncertainty in medicine and in life. Growing up as the daughter of a dedicated surgeon, Elizabeth L. Silver felt an unquestioned faith in medicine. When her six-week-old daughter, Abby, was rushed to the Neonatal Intensive Care Unit with sudden seizures, and scans revealed a serious brain bleed, her relationship to medicine began to change. The Tincture of Time is Silver’s gorgeous and haunting chronicle of Abby’s first year. It’s a year of unending tests, doctors’ opinions, sleepless nights, promising signs and steps backward, and above all, uncertainty: The mysterious circumstances of Abby’s hospitalization attract dozens of specialists, none of whom can offer a conclusive answer about what went wrong or what the future holds. As Silver explores what it means to cope with uncertainty as a patient and parent and seeks peace in the reality that Abby’s injury may never be fully understood, she looks beyond her own story for comfort, probing literature and religion, examining the practice of medicine throughout history, and reporting the experiences of doctors, patients, and fellow caretakers. The result is a brilliant blend of personal narrative and cultural analysis, at once a poignant snapshot of a parent’s struggle and a wise meditation on the reality of uncertainty, in and out of medicine, and the hard-won truth that time is often its only cure. Heart-wrenching, unflinchingly honest, and beautifully written, The Tincture of Time is a powerful story of parenthood, an astute examination of the boundaries of medicine, and an inspiring reminder of life’s precariousness.
Author : L. Syd M. Johnson Publisher : Oxford University Press Page : 305 pages File Size : 44,8 Mb Release : 2022 Category : Medical ISBN : 9780190943646
The Ethics of Uncertainty by L. Syd M. Johnson Pdf
"Consciousness isn't a thing you can poke a stick at. It's not a natural kind, like a bit of quartz, or quarks, or water. Like "life," which can be attributed to many entities, but is not a thing with reality apart from living entities, consciousness can be attributed to conscious entities without being some further thing or fact, some mysterious, mentalizing "force" that can exist without conscious entities. It is manifested in conscious states and creatures, but isn't a thing in and of itself. One of the enduring puzzles about consciousness and conscious states is how they, as apparently mental, nonphysical states, can manifest in a physical entity like a brain. We can point to a physical bit of brain, to a neuron, or a structure like the thalamus, but we can't locate the consciousness within that bit of brain or its neural cells"--
Essential, required reading for doctors and patients alike: A Pulitzer Prize-winning author and one of the world’s premiere cancer researchers reveals an urgent philosophy on the little-known principles that govern medicine—and how understanding these principles can empower us all. Over a decade ago, when Siddhartha Mukherjee was a young, exhausted, and isolated medical resident, he discovered a book that would forever change the way he understood the medical profession. The book, The Youngest Science, forced Dr. Mukherjee to ask himself an urgent, fundamental question: Is medicine a “science”? Sciences must have laws—statements of truth based on repeated experiments that describe some universal attribute of nature. But does medicine have laws like other sciences? Dr. Mukherjee has spent his career pondering this question—a question that would ultimately produce some of most serious thinking he would do around the tenets of his discipline—culminating in The Laws of Medicine. In this important treatise, he investigates the most perplexing and illuminating cases of his career that ultimately led him to identify the three key principles that govern medicine. Brimming with fascinating historical details and modern medical wonders, this important book is a fascinating glimpse into the struggles and Eureka! moments that people outside of the medical profession rarely see. Written with Dr. Mukherjee’s signature eloquence and passionate prose, The Laws of Medicine is a critical read, not just for those in the medical profession, but for everyone who is moved to better understand how their health and well-being is being treated. Ultimately, this book lays the groundwork for a new way of understanding medicine, now and into the future.
National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care
Author : National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care Publisher : National Academies Press Page : 473 pages File Size : 49,7 Mb Release : 2015-12-29 Category : Medical ISBN : 9780309377720
Improving Diagnosis in Health Care by National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care Pdf
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.