Broomedocs POdcast
Decision Rules Destroying Medicine
Nov 3, 2023
Dr. Justin Morgenstern, a medical expert in emergency medicine, dives into the world of Clinical Decision Rules and their impact on patient care. He discusses how these tools can sometimes fail to improve outcomes, emphasizing the complexity of decision-making in urgent situations. The conversation touches on the potential pitfalls of relying too heavily on decision rules during medical training and the challenges of diagnostic testing in emergency settings. Morgenstern advocates for a balanced approach that prioritizes clinical judgment over rigid guidelines.
36:42
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Quick takeaways
- Clinical decision rules often fail to outperform clinical judgment, raising doubts about their effectiveness in improving patient outcomes.
- The introduction of AI in clinical decision-making holds promise, but must avoid replicating the issues faced by existing decision rules.
Deep dives
The Essence of Clinical Decision Rules
Clinical decision rules are developed through a three-step process: derivation, validation, and implementation. Derivation involves analyzing large data sets to formulate a rule, while validation tests the rule in different populations to assess its reliability. Yet, the most critical aspect is implementation, as simply applying these rules does not guarantee improved patient outcomes. The current reality is that many decision rules have not been validated against clinical judgment, raising concerns about their actual effectiveness in changing practice for the better.
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