Forecasting, uncertainty and risk; perspectives on clinical decision-making in preventive and curative medicine

Spyros Makridakis, Richard Kirkham, Ann Wakefield, Maria Papadaki, Joanne Kirkham, Lisa Long

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Should we screen the population routinely for the presence of breast or prostatic cancer? This simple proposition masks a landscape of complexities, including the economics of screening, the prevalence and probability of the disease, desired frequencies of intervention and a willingness to adopt preventive screening. These ‘risk factors’ form part of a broader landscape of uncertainty that characterises the intricacies of clinical decision-making. Deepening our understanding of the way in which clinicians evaluate risk and uncertainty requires a framing of insights into language, communication, psychology and epistemology. This paper explores perspectives in forecasting and uncertainty as a basis for understanding individuals’ perceptions of risk when assessing their options in both preventative and curative medicine. At the heart of the issue is the prevalence of diagnostic error; this paper argues for the use of systematised approaches to medical error management and inclusive approaches to research in the field. The advantages of augmenting the management of unforeseen consequences through an improved understanding of the issues that are of concern to patients, carers, and medical practitioners alike forms a key construct in this paper. We conclude with an exploration of potential opportunities for improvements in medical practice: changes that may reduce the disbenefits of uncertainty and enhance the management of the general risks associated with clinical decision-making.

Original languageEnglish
Pages (from-to)659-666
Number of pages8
JournalInternational Journal of Forecasting
Volume35
Issue number2
DOIs
Publication statusPublished - 1 Apr 2019

Fingerprint

Medicine
Clinical decision making
Uncertainty
Risk and uncertainty
Screening
Risk factors
Cancer
Psychology
Diagnostics
Language
Epistemology
Individual perception
Medical errors
Communication
Medical practice
Carers
Economics
Willingness

Keywords

  • Correct treatment
  • Diagnostic accuracy
  • Medical errors
  • Medical predictions
  • Medical research
  • Medical reversals
  • Preventive screening
  • Risk
  • Uncertainty

Cite this

Makridakis, Spyros ; Kirkham, Richard ; Wakefield, Ann ; Papadaki, Maria ; Kirkham, Joanne ; Long, Lisa. / Forecasting, uncertainty and risk; perspectives on clinical decision-making in preventive and curative medicine. In: International Journal of Forecasting. 2019 ; Vol. 35, No. 2. pp. 659-666.
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Forecasting, uncertainty and risk; perspectives on clinical decision-making in preventive and curative medicine. / Makridakis, Spyros; Kirkham, Richard; Wakefield, Ann; Papadaki, Maria; Kirkham, Joanne; Long, Lisa.

In: International Journal of Forecasting, Vol. 35, No. 2, 01.04.2019, p. 659-666.

Research output: Contribution to journalArticle

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