Decision-making in clinical practice: "4E" evidence-based framework proposal

background: Human decisions are partially rational. In medicine, critical scenarios make decide-making (DM) difficult. In this review, we propose the "4E" approach to improve the DM of interventions. The "4E" approach includes decisions: "effectual" when interventions h...

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Detalles Bibliográficos
Autores: Alva-Diaz, Carlos, Velásquez-Rimachi, Victor, Sequeiros, Joel, Pacheco-Barrios, Kevin
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:Perú
Institución:Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
Repositorio:Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
Idioma:español
OAI Identifier:oai:cmhnaaa_ojs_cmhnaaa.cmhnaaa.org.pe:article/839
Acceso en línea:https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/839
Access Level:acceso abierto
Palabra clave:medicina basada en evidencia
gestión clínica
toma de decisiones
evidence-based medicine
clinical management
decision-making process
Descripción
Sumario:background: Human decisions are partially rational. In medicine, critical scenarios make decide-making (DM) difficult. In this review, we propose the "4E" approach to improve the DM of interventions. The "4E" approach includes decisions: "effectual" when interventions have been tested in controlled settings, "effective" when interventions have been tested in uncontrolled or pragmatic clinical settings, "efficient" when the benefits of a new intervention are evaluated by its costs, and decisions that promote "equity" when these interventions are recommended according to the needs of the patient, avoiding barriers. Using this approach could improve DM in clinical practice, but it is not enough to guarantee its incorporation and use. It is also essential to promote the organizational, institutional, and political dynamics of health systems that promote evidence's critical use to make decisions.