<i>Annals</i> Clinical Decision Making: Incorporating Perspective Into Clinical Decisions
Authors: Joshua P. Metlay, Katrina A. Armstrong
Journal: Annals of Internal Medicine (2020)

Special Articles2 June 2020Annals Clinical Decision Making: Incorporating Perspective Into Clinical DecisionsJoshua P. Metlay, MD, PhD and Katrina A. Armstrong, MD, MSJoshua P. Metlay, MD, PhDMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (J.P.M., K.A.A.) and Katrina A. Armstrong, MD, MSMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (J.P.M., K.A.A.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3469 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This series on clinical decision making has focused on the incorporation of principles from epidemiology and cognitive sciences to inform clinical decisions made by physicians and other clinical providers. Until this point, the series has adopted the perspective of the treating physician in reaching a clinical decision. But the delivery of medical care involves multiple other stakeholders who bring different perspectives to the decision. Payors, regulators, hospitals, and public health agencies are responsible for outcomes at levels other than that of an individual patient, may value outcomes differently, and can influence clinical care through financial and regulatory levers. Because the ...References1. Armstrong KA, Metlay JP. Annals clinical decision making: translating population evidence to individual patients. Ann Intern Med. 2020;172:610-6. doi:10.7326/M19-3496 LinkGoogle Scholar2. Morley C, Unwin M, Peterson GM, et al. Emergency department crowding: a systematic review of causes, consequences and solutions. PLoS One. 2018;13:e0203316. [PMID: 30161242] doi:10.1371/journal.pone.0203316 CrossrefMedlineGoogle Scholar3. Levine DM, Ouchi K, Blanchfield B, et al. Hospital-level care at home for acutely ill adults: a randomized controlled trial. Ann Intern Med. 2019. [PMID: 31842232]. doi:10.7326/M19-0600 LinkGoogle Scholar4. Hershey JC, Asch DA, Thumasathit T, et al. The roles of altruism, free riding, and band wagoning in vaccination decisions. Organ Behav Hum Decis Process. 1994;59:177-87. doi:10.1006/obhd.1994.1055 CrossrefGoogle Scholar5. Martinez KA, Rood M, Jhangiani N, et al. Antibiotic prescribing for respiratory tract infections and encounter length: an observational study of telemedicine [Letter]. Ann Intern Med. 2019;170:275-277. [PMID: 30285078]. doi:10.7326/M18-2042 LinkGoogle Scholar6. Metlay JP, Shea JA, Crossette LB, et al. Tensions in antibiotic prescribing: pitting social concerns against the interests of individual patients. J Gen Intern Med. 2002;17:87-94. [PMID: 11841523] CrossrefMedlineGoogle Scholar7. Centers for Disease Control and Prevention. Preventing and treating bronchitis. Accessed at www.cdc.gov/antibiotic-use/community/downloads/Preventing-Treating-Bronchitis-p.pdf on 20 October 2019. Google Scholar8. Daniel H, Bornstein SS, Kane GC; Health and Public Policy Committee of the American College of Physicians. Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Ann Intern Med. 2018;168:577-578. [PMID: 29677265]. doi:10.7326/M17-2441 LinkGoogle Scholar9. Casalino LP, Elster A, Eisenberg A, et al. Will pay-for-performance and quality reporting affect health care disparities? Health Aff (Millwood). 2007;26:w405-14. [PMID: 17426053] CrossrefMedlineGoogle Scholar10. Centers for Medicare & Medicaid Services. Disparity methods confidential reporting. Accessed at www.qualitynet.org/inpatient/measures/disparity-methods on 14 January 2020. Google Scholar11. Massachusetts General Hospital. Annual report on equity in health care quality. Accessed at www.mghdisparitiessolutions.org/equity-in-health-care-quality on 10 March 2020. Google Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (J.P.M., K.A.A.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3469.Corresponding Author: Joshua P. Metlay, MD, PhD, Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Metlay: Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114.Dr. Armstrong: Massachusetts General Hospital, Gray-Bigelow 7, 55 Fruit Street, Boston, MA 02114.Author Contributions: Conception and design: J.P. Metlay, K.A. Armstrong.Drafting of the article: J.P. Metlay, K.A. Armstrong.Critical revision of the article for important intellectual content: J.P. Metlay, K.A. Armstrong.Final approval of the article: J.P. Metlay, K.A. Armstrong.Administrative, technical, or logistic support: J.P. Metlay, K.A. Armstrong.Collection and assembly of data: J.P. Metlay.This article was published at Annals.org on 21 April 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Decision Making: Nurturing Our Core Skills Darren B. Taichman , Sankey V. Williams , and Christine Laine Clinical Decision Making: Nurturing Our Core Skills Darren B. Taichman , Sankey V. Williams , and Christine Laine Metrics Cited byThe future of research in hematology: Integration of conventional studies with real-world data and artificial intelligenceShared Decision MakingClinical Decision Making During the COVID-19 PandemicJoshua P. Metlay, MD, PhD and Katrina A. Armstrong, MD, MSCEAnnals Clinical Decision Making: Using a Diagnostic TestKatrina A. Armstrong, MD, MS and Joshua P. Metlay, MD, PhDAnnals Clinical Decision Making: Weighing Evidence to Inform Clinical DecisionsJoshua P. Metlay, MD, PhD and Katrina A. Armstrong, MD, MSClinical Decision Making: Nurturing Our Core SkillsDarren B. Taichman, MD, PhD, Executive Editor, Sankey V. Williams, MD, Deputy Editor, and Christine Laine, MD, MPH, Editor in Chief Using the Causal Inference Framework to Support Individualized Drug Treatment Decisions Based on Observational Healthcare Data 2 June 2020Volume 172, Issue 11Page: 743-746KeywordsAntibioticsDecision makingHealth careHospital medicineHospitalizationsInpatientsOutpatient clinicsPatientsPneumoniaPrevention, policy, and public health ePublished: 21 April 2020 Issue Published: 2 June 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...