临床决策原理及其能力培养

发布时间：2018-01-19 20:58

本文关键词： 临床决策临床思维诊断误诊共同决策模式识别　出处：《中华诊断学电子杂志》2015年04期 　论文类型：期刊论文

【摘要】：临床决策是医疗实践的核心环节,决策水平反映医生的业务能力。常用的临床决策方法有两种:"模式识别"和"系统分析",前者依赖个人经验,决策迅速;而后者主要用于处理复杂、疑难或陌生的临床问题,费时较多。不断丰富和完善医生的个人经验,有助于提高模式识别的水平。系统分析分为四个步骤:(1)确定临床问题;(2)掌握解决问题所需要的资源;(3)列举所有可能的选择并加以比较;(4)做出决策并加以评估。无论用何种方法做出决策,都需要密切随访观察,追踪病情变化,以肯定或修正原有判断。临床决策是医学教育的重要内容,掌握其原理和方法有助于医学生及年轻医生更好、更快地成长。
[Abstract]:Clinical decision making is the core link of medical practice, and the level of decision-making reflects the professional ability of doctors. There are two commonly used clinical decision-making methods: pattern recognition and system analysis. The former relies on personal experience and makes quick decisions. The latter is mainly used to deal with complex, difficult or unfamiliar clinical problems, more time-consuming, constantly enrich and improve the personal experience of doctors. It is helpful to improve the level of pattern recognition. Systematic analysis is divided into four steps: 1) to identify clinical problems; (2) to master the resources needed to solve the problem; (III) enumerate and compare all possible options; 4) to make decision and evaluate it. No matter what method is used, it is necessary to follow up closely and follow up the changes of the condition in order to confirm or correct the original judgment. The clinical decision is an important part of medical education. Mastering its principles and methods helps medical students and young doctors grow better and faster.
【作者单位】：中国医学科学院北京协和医院消化内科;
【基金】：首都卫生发展科研专项(首发2011-4001-01)
【分类号】：G642;R-4
【正文快照】： 临床工作离不开各式各样的决策,临床决策的范围甚广,涵盖诊断、治疗、监测以及判断预后等诸多方面。例如“为明确诊断需要做哪些检查?”“该患者需使用何种抗生素,剂量多大?”“患者的病情走势符合预期吗?”“需要多长时间随诊一次?”,这些问题等都属于临床决策的范畴。研究表

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