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Chapter3:BiomedicalDecisionMaking:ProbabilisticClinicalReasoningMedicalpracticeismedicaldecisionmaking.wediscusswaysthatcomputerscanhelpclinicianswiththedecision-makingprocess,andweemphasizetherelationshipbetweeninformationneedsandsystemdesignandimplementation.1.Whatareproblemsindecisionmaking?Clinicaldataareimperfectandoutcomesoftreatmentareuncertain,healthprofessionalsoftenarefacedwithdifficultchoices.1/7Chapter3:BiomedicalDecisionMaking:ProbabilisticClinicalReasoning2.Probability:AnAlternativeMethodofExpressingUncertaintyFigure3.1.Probabilityanddescriptiveterms.Differentphysiciansattachdifferentmeaningstothesameterms。2/7Chapter3:BiomedicalDecisionMaking:ProbabilisticClinicalReasoning3.TheDiagnosticProcessSeparatethediagnosticprocessintothreestages:Makinganinitialjudgment:implicit->explicit,priorprobabilityorpretestprobability.GatheringmoreinformationfordeductionuncertaintyUpdatetheinitialprobabilityestimate:posteriorprobability,orpost-testprobabilityTheeffectoftestresultsontheprobabilityofdisease.(a)Apositivetestresultincreasestheprobabilityofdisease.(b)Test2reducesuncertaintyaboutpresenceofdiseasemorethantest1does.3/7Chapter3:BiomedicalDecisionMaking:ProbabilisticClinicalReasoning4.Whataredecisionmakingbasedon?Somedecisionsaremadeonthebasisofdeductivereasoningorofphysiologicalprinciples.Manydecisions,however,aremadeonthebasisofknowledgethathasbeengainedthroughcollectiveexperience:theclinicianoftenmustrelyonempiricalknowledgeofassociationsbetweensymptomsanddiseasetoevaluateaproblem.MethodstoAssessPretestProbabilitySubjectiveProbabilityAssessment:basedonpersonalexperience.ObjectiveProbabilityEstimates:basedonpublishedresearchresults4/7Chapter3:BiomedicalDecisionMaking:ProbabilisticClinicalReasoningAdecisionthatisbasedontheseusuallyimperfectassociationswillbe,tosomedegree,uncertain.Afalsepositive:thetestresultincorrectlyclassifiesthepatientashavingthediseaseAfalsenegative:the
