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How clinical decisions are made
Author(s) -
Bate Louise,
Hutchinson Andrew,
Underhill Jonathan,
Maskrey Neal
Publication year - 2012
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.2012.04366.x
Subject(s) - satisficing , process (computing) , computer science , information processing , quality (philosophy) , decision quality , decision support system , r cast , bounded rationality , rationality , key (lock) , business decision mapping , cognition , risk analysis (engineering) , decision engineering , management science , psychology , knowledge management , artificial intelligence , medicine , cognitive psychology , philosophy , team effectiveness , computer security , epistemology , neuroscience , political science , law , economics , operating system
There is much variation in the implementation of the best available evidence into clinical practice. These gaps between evidence and practice are often a result of multiple individual decisions. When making a decision, there is so much potentially relevant information available, it is impossible to know or process it all (so called ‘ bounded rationality ’). Usually, a limited amount of information is selected to reach a sufficiently satisfactory decision, a process known as satisficing . There are two key processes used in decision making: System 1 and System 2. System 1 involves fast, intuitive decisions; System 2 is a deliberate analytical approach, used to locate information which is not instantly recalled. Human beings unconsciously use System 1 processing whenever possible because it is quicker and requires less effort than System 2. In clinical practice, gaps between evidence and practice can occur when a clinician develops a pattern of knowledge, which is then relied on for decisions using System 1 processing, without the activation of a System 2 check against the best available evidence from high quality research. The processing of information and decision making may be influenced by a number of cognitive biases, of which the decision maker may be unaware. Interventions to encourage appropriate use of System 1 and System 2 processing have been shown to improve clinical decision making. Increased understanding of decision making processes and common sources of error should help clinical decision makers to minimize avoidable mistakes and increase the proportion of decisions that are better .