01 March 2006
Discounting and risk characteristics in clinical decision-making.
Monica Ortendahl, James F. FriesMed Sci Monit 2006; 12(3): RA41-45 :: ID: 447118
Abstract
Time-related aspects have attracted an increasing interest in medical decisions.Health promotion often works toward remote goals, and many clinical judgments and decisions include anexchange of costs today for benefits in the future. The concept of diminishing value over time is positivediscounting when the benefits occur so far in the future that they seem of little value relative to theimmediate cost. If there is a preference to live for the present rather than save for the future, sucha preference might not contribute to good health according to a lower discount rate. As discounting isrelated to risk an analysis of uncertainty is required being an unavoidable condition in health work.Shared decision-making between doctor and patient has increasingly been emphasized, where risk characteristicsand time-related aspects should be taken into account to reach a decision based upon mutual agreement.The framework of time and risk for analysis can perform a useful role in clinical judgments and decisions,where framing of different features of risk might diminish discounting and increase compliance to treatment.A summary of valuation factors in medical decision making is presented: (a) long-term decisions are sensitiveto discount rates; (b) discount rates vary by domain, by outcome, by individuals and by level of certainty;(c) probability discounting is used if the risk is perceived as controllable; (d) the doctor uses expectedvalue, the patient is risk aversive; (e) asymmetric discounting for patients and doctors gives poor compliance;(f) discount rates are influenced by framing.
Keywords: Attitude to Health, Attitude of Health Personnel, Costs and Cost Analysis, Decision Making, Physician-Patient Relations, Risk Factors, Uncertainty
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
06 Mar 2024 : Clinical Research
Prevalence and Variation of Medical Comorbidities in Oral Surgery Patients: A Retrospective Study at Jazan ...Med Sci Monit In Press; DOI: 10.12659/MSM.943884
08 Mar 2024 : Clinical Research
Evaluation of Foot Structure in Preschool Children Based on Body MassMed Sci Monit In Press; DOI: 10.12659/MSM.943765
15 Apr 2024 : Laboratory Research
The Role of Copper-Induced M2 Macrophage Polarization in Protecting Cartilage Matrix in OsteoarthritisMed Sci Monit In Press; DOI: 10.12659/MSM.943738
07 Mar 2024 : Clinical Research
Knowledge of and Attitudes Toward Clinical Trials: A Questionnaire-Based Study of 179 Male Third- and Fourt...Med Sci Monit In Press; DOI: 10.12659/MSM.943468
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952