Moreover, the current health care environment increasingly demands that physicians be able to justify clinical policies and decisions with an evidence-based, quantitative approach. We have two principal goals in this subsection. The first is to provide a basic explanation of the measurements used in critical appraisal of the literature and the ways in which physicians interpret these measurements in evidence-based clinical decision making. Scientific American Medicine itself is prepared in a heavily referenced fashion and is regularly updated to provide readers with summaries of such evidence. The second goal is to introduce the topic of medical decision analysis.
Clinicians use decision analysis in two ways.
For example, the use of practice guidelines is becoming increasingly widespread and now influences many of the quick, straightforward decisions that occur in daily practice. Many of these guidelines are based on formal decision analyses. It is important not to misunderstand this effort to achieve precision and quantitation in measurement and decision making as being in any way opposed to quality or qualitative assessment. Anything that can be measured at all, even if only qualitatively, can be counted and turned into a quantitative measure of the sort that can be clinically useful. We believe that practitioners must not cede their responsibility for clinical decision making to others, because any clinical decisions must take into account not only the evidence available and the guidelines in force but also the patient's unique circumstances and individual wishes.