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September 13, 1976

Clinical Decision Analysis: The Hazard of Using Additional Data

Author Affiliations

From the Department of Internal Medicine, Division of Nuclear Medicine, University of Michigan Medical Center, Ann Arbor. Dr Schoomaker is now with the Department of Human Genetics, University of Michigan Medical Center, Ann Arbor; Dr Ross is with the Department of Pathology, Stanford University, Palo Alto, Calif.

JAMA. 1976;236(11):1259-1263. doi:10.1001/jama.1976.03270120035022

Acquisition of laboratory data bearing on a clinical problem may make patient care worse rather than better. The hazards of obtaining new information, that go beyond the monetary costs and risks to physical well-being, are frequently not appreciated by physicians.

In the complex and many-faceted practice of medicine, intuition, even when expressed by experienced clinicians, may lead to faulty judgments. Decision analysis gives a systematic exposition of clinical management, and lessens, if not eliminates, the influence of biased and unreliable intuition. With practice, most physicians could employ decision analysis to help solve moderately complicated problems at the bedside or in the office. Use of this tactic will make gaps in knowledge explicit, and may thereby stimulate investigations to ensure better clinical judgments in the future.

(JAMA 236:1259-1263, 1976)