DECISION MAKING IN CLINICAL PRACTICE

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Jordi Castarlenas

AGREEMENTS

May 2, 2024

In the dynamic world of medicine, no two patients are alike. Doctors strive to keep up with the latest publications and therapeutic and/or clinical advances, always seeking to identify the unique needs of each patient. Their goal: to make decisions backed by solid evidence that ensures the right decision for each patient at the right time. However, various obstacles can make this task less straight forward than we would like.

In the dynamic world of medicine, no two patients are alike. Doctors strive to keep up with the latest publications and therapeutic and/or clinical advances, always seeking to identify the unique needs of each patient. Their goal: to make decisions backed by solid evidence that ensures the right decision for each patient at the right time. However, various obstacles can make this task less straight forward than we would like.

Healthcare professionals must make quick and effective decisions in many situations. These decisions may involve referring a patient to another specialist, ordering tests to diagnose or start treatment, and many depend on the correct application of existing evidence. However, medicine is a science that is constantly changing, and each patient is different, which means that there is not always evidence available to guide the clinician or it is not known. This is due to two opposing situations. On the one hand, the multiple difficulties in conducting studies that do not always allow us to have all the evidence we need. On the other hand, the amount of scientific literature available. According to recent bibliometric data, the number of scientific articles published has grown between 8 and 9% each year in recent decades. ¹ Only in the biomedical field, more than a million articles are published each year in the PubMed database, that is, about two articles per minute. ¹

The result of this implies that the clinical criterion is not the same between two doctors in similar situations since the evidence that supports it is not always available or simply, it is not known by everyone.

Faced with this variability in clinical decisions, there is a need for consensus among health professionals to ensure less variability in clinical practice and therefore, higher quality care results.

Consensus is a different approach to clinical practice guidelines, Although the development of these consensus involves an equally rigorous process it can also be slow. In addition, the amount of scientific literature to review in both cases is overwhelming and keeping them up to date with all the new monthly publications, requires constant time and dedication that healthcare professionals do not have.

In this context, two main gaps are identified:

• The care reality does not allow the necessary time to review and implement the new evidence in daily life.

• Heterogeneity is generated in the decision-making in clinical practice.

In an ideal world, all treatment algorithms would be evidence-based and all pathologies would have updated guidelines. But the reality is that medicine and the generation of new data advances at an accelerated pace motivated by the emergence of new treatments, new knowledge about pathophysiology or disease progression, as well as new diagnostic and clinical follow-up tools that constantly emerge.

How can we approach this ideal world?

The answer is in the solution developed by GOC. This innovative product’s main objective is to generate agreements of expert groups quickly and agilely, providing efficient answers to specific clinical questions.

The benefits of this solution are clear:

Agility: It allows obtaining quick recommendations, facilitating healthcare professionals to make informed decisions in real time.

Consistency: The recommendations are based on the agreement of expert groups, ensuring consistency, and reflecting current best practices.

Efficiency: By reducing the time needed to get answers to specific clinical questions, resources are optimized, and patient care is improved.

In summary, daily clinical practice presents unique challenges that require informed decisions based on experience and clinical judgment based on data. The solution proposed by GOC accompanies the pace at which we must generate these support tools for the improvement of the quality and efficiency of medical care, through the agile generation of agreements based on the experience of experts.

 

Are you ready to join the revolution of reaching agile and updated agreements?

  1. Landhuis, E. Scientific literature: Information overload. Nature 535, 457–458 (2016). https://doi.org/10.1038/nj7612-457a