Medical decision making: a selective review for child psychiatrists and psychologists

Galanter, Cathryn A.; Patel, Vimla L.

doi:10.1111/j.1469-7610.2005.01452.x

Cited by 98 publications

(75 citation statements)

References 92 publications

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“…Although the vignette did not directly reflect symptoms of these mood disorders, irritability is a valid symptom criterion for depression, so this is not entirely surprising. This variability in diagnostic assignment is consistent with other studies documenting a lack of reliability and consistency in mental health diagnoses for children across reporters and/or diagnostic assessment methods [33,42,43].…”

Section: Physician Decision-making For Children With Disruptive Behavsupporting

confidence: 76%

Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems?

Garland

Taylor

Brookman‐Frazee

et al. 2014

J. Racial and Ethnic Health Disparities

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Race/ethnic disparities in utilization of children's mental health care have been well documented and are particularly concerning given the long-term risks of untreated mental health problems (Institute of Medicine, 2003; Kessler et al. Am J Psychiatry 152:10026-1032. Research investigating the higher rates of unmet need among race/ethnic minority youths has focused primarily on policy, fiscal, and individual child or family factors that can influence service access and use. Alternatively, this study examines provider behavior as a potential influence on race/ethnic disparities in mental health care. The goal of the study was to examine whether patient (family) race/ethnicity influences physician diagnostic and treatment decision-making for childhood disruptive behavior problems. The study utilized an internet-based video vignette with corresponding survey of 371 randomly selected physicians from across the USA representing specialties likely to treat these patients (pediatricians, family physicians, general and child psychiatrists). Participants viewed a video vignette in which only race/ethnicity of the mother randomly varied (nonHispanic White, Hispanic, and African American) and then responded to questions about diagnosis and recommended treatments. Physicians assigned diagnoses such as oppositional defiant disorder (48 %) and attention deficit disorder (63 %) to the child, but there were no differences in diagnosis based on race/ethnicity. The majority of respondents recommended psychosocial treatment (98 %) and/or psychoactive medication treatment (60 %), but there were no significant differences based on race/ethnicity. Thus, in this study using mock patient stimuli and controlling for other factors, such as insurance coverage, we did not find major differences in physician diagnostic or treatment decision-making based on patient race/ethnicity.

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Section: Physician Decision-making For Children With Disruptive Behavsupporting

confidence: 76%

Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems?

Garland

Taylor

Brookman‐Frazee

et al. 2014

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

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“…There have been considerable efforts to make explicit the processes involved in clinical reasoning (e.g., Borleffs, Custers, van Gijn, & ten Cate, 2003;Elstein, Shulman, & Sprafka, 1978;Falvey, Bray, & Hebert, 2005;Schmidt, Norman, & Boshuizen, 1990), and to apply models of decisionmaking to clinical reasoning (e.g., Galanter & Patel, 2005;Ward, Vertue, & Haig, 1999).…”

mentioning

confidence: 99%

An abductive perspective on clinical reasoning and case formulation

Vertue

Haig

2008

J Clin Psychol

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Clinical reasoning has traditionally been understood in terms of either hypothetico-deductive or Bayesian methods. However, clinical psychology requires an organizing framework that goes beyond the limits of these methods and characterizes the full range of reasoning processes involved in the description, understanding, and formulation of the difficulties presented by clients. In this article, the authors present a framework for clinical reasoning and case formulation that is largely based on a broad abductive theory of scientific method (Haig, 2005b). The abductive theory articulates and combines the processes of phenomena detection and theory construction. Both of these processes are applied to clinical reasoning and case formulation, and a running case example is provided to illustrate the application.

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“…Research in other fields such as medicine and psychiatry showed that structured decision making can increase the reliability of treatment decisions (Galanter & Patel, 2005;Garb, 2005). In (mental) health care, introducing a (computerized) decision support system has improved practitioners' performance, for example, disease management, drug dosing, or transparency of the decisions (Garg et al, 2005;Witteman & Kunst, 1999).…”

Section: Decision Support For Intervention Plansmentioning

confidence: 99%

Improving Agreement About Intervention Plans in Probation by Decision Support

Bosker

Witteman

Hermanns

et al. 2014

Int J Offender Ther Comp Criminol

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Reliability in decision making about intervention plans is a necessary condition for evidence-based probation work and equal treatment of offenders. Structuring decision making can improve agreement between clinical decision makers. In a former study however, we found that in Dutch probation practice structured risk and needs assessment did not result in acceptable agreement about intervention plans. The Dutch probation services subsequently introduced a tool for support in decision making on intervention plans. This article addresses the question whether the use of this tool results in better agreement between probation officers. A significant and meaningful improvement in agreement was found on all domains of the intervention plan. Implications for probation practice are discussed.

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Medical decision making: a selective review for child psychiatrists and psychologists

Cited by 98 publications

References 92 publications

Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems?

Does Patient Race/Ethnicity Influence Physician Decision-Making for Diagnosis and Treatment of Childhood Disruptive Behavior Problems?

An abductive perspective on clinical reasoning and case formulation

Improving Agreement About Intervention Plans in Probation by Decision Support

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