Support for management medical decisions and the nature of uncertainty in them

S.Yu. Zhuleva, A. Kroshilin, S. Kroshilina
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Abstract

The process of making a medical decision is characterized by a lack of knowledge and inconsistency of the available information, the lack of the possibility of attracting competent medical experts, limited time resources, incomplete or inaccurate information about the patient's condition. These aspects may be the causes of medical errors, which lead to further aggravation of the problem situation. Purpose – it is necessary to define and justify managerial medical decisions and types of medical information in conditions of uncertainty, when each variant of the sets of outcomes of the situation (recommendations) has its own unique set of values. The fundamental difference between this process for medical use is the concept of the "best medical solution", in which the key role is given to the patient's state of health in obtaining and evaluating alternatives, as well as the need to take into account the time, adverse reactions of the body and the costs of implementing this solution. In the medical field, support for medical decision-making can be classified as organizational-managerial and therapeutic-diagnostic, but both are determined by the position of the person making the medical decision and are aimed at effective management of the medical institution as a whole. The article describes the causes and factors of the nature of uncertainty in the tasks of supporting medical decision-making in medical-diagnostic and organizational-managerial areas. The analysis of the features of supporting medical decision-making in conditions of uncertainty is carried out. Approaches and directions in this area, as well as the concept of “solution”, are considered. The essence of the management medical decision is reflected. The classification of management medical decisions is given, the requirements that are imposed on them are highlighted. The features of the development of management medical solutions in the conditions of incompleteness and uncertainty, the problems that arise when they are implemented in information systems are presented. The general scheme of the process of creating a management medical solution is shown. The features of making group and individual decisions are reflected. The algorithm of actions of the person making the medical decision in the conditions of uncertainty, incompleteness and risk in medical subject areas is presented.
支持管理医疗决策及其不确定性的性质
作出医疗决定的过程的特点是缺乏知识和现有信息不一致,不可能吸引称职的医疗专家,时间有限,关于病人病情的信息不完整或不准确。这些方面都可能是造成医疗差错的原因,从而导致问题情况进一步恶化。目的——有必要在不确定的条件下界定和证明管理医疗决策和医疗信息的类型,因为情况的结果集(建议)的每一种变体都有其独特的一套价值。这一用于医疗用途的过程之间的根本区别在于"最佳医疗解决方案"的概念,其中在获得和评估替代方案方面,病人的健康状况发挥了关键作用,并且需要考虑到实施这一解决方案的时间、身体的不良反应和成本。在医疗领域,对医疗决策的支持可以分为组织-管理和治疗-诊断两种,但两者都是由做出医疗决策的人所处的位置决定的,目的是对整个医疗机构进行有效的管理。本文描述了在医疗诊断和组织管理领域支持医疗决策任务的不确定性性质的原因和因素。对不确定条件下辅助医疗决策的特点进行了分析。讨论了这一领域的方法和方向,以及“解决”的概念。体现了管理医疗决策的本质。给出了管理医疗决策的分类,强调了对管理医疗决策的要求。介绍了管理医疗方案在不完备和不确定条件下的发展特点,以及在信息系统中实施时出现的问题。给出了创建管理医疗解决方案过程的总体方案。体现了群体决策和个体决策的特点。提出了医学学科领域中不确定性、不完全性和风险条件下医疗决策人的行为算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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