Annals of Decision-Making

By MICHEL ACCAD, MD A Vox.com piece about decision-making caught my attention this morning. The story was compelling.  A 12-year-old boy had intractable seizures from a leaking vascular malformation in the brain.  A first neurosurgeon would not operate and recommended radiation therapy instead.  The patient’s mother sought another opinion from a Mayo Clinic neurosurgeon who was adamant that an operation should be undertaken.  The second surgeon surgeon was undeniably right.  The patient is now a bright, fully-functional researcher at the University of California San Francisco. So far, so good?  Not so, according to Vox.  That there should be a smart mom making a smart decision, and a smart doctor carrying out a successful surgery is apparently a problem. Why?  Because the more cautious surgeon had a different opinion and, had the mom compliantly accepted his recommendation, the child could have been worse off.  Variability in judgment, as always, is the enemy. Vox quotes a recent Annals of Surgery study that “supports” the concern.  When surgeons are given clinical vignettes, they vary widely in how they estimate the risks and benefits of an operation.  Consequently, the decision to operate also varies widely—at least, on vignette paper. This variation seemed to come down to surgeons’ perceptions of risks and benefits, the researchers wrote: “Surgeons were less likely to operate as their perceptions of operative risk increased and their...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs