Clinical decision making: from theory to practice. Anatomy of a decision

JAMA. 1990 Jan 19;263(3):441-3. doi: 10.1001/jama.263.3.441.


KIE: Eddy argues that the quality of medical care is determined mainly by the quality of the decisions that determine what that care will be and the quality with which that care is executed. While the medical profession understands the importance of ensuring quality of execution, it has not taken steps to develop and evaluate quality decision making. Eddy describes the two main steps that make up the "anatomy" of a decision, the first a largely fact-based analysis of the estimated outcomes of various care plans, and the second a more personal and subjective comparison of the desirability of the outcome of each option. Eddy also identifies the "pathology" of decisions resulting from misperceptions about outcomes of care options, or about the values that patients place upon those outcomes. He identifies three principles that, if attended to, should enable physicians to achieve the goal of improving patient outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / therapy
  • Decision Making*
  • Female
  • Humans
  • Risk Assessment*
  • Social Values