Clinical decision-making for shoulder surgery referral: An art or a science?
health economics
healthcare
practical reasoning
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
31
07
2020
received:
24
03
2020
accepted:
04
08
2020
pubmed:
18
9
2020
medline:
28
10
2021
entrez:
17
9
2020
Statut:
ppublish
Résumé
Decision-making in musculoskeletal health care is complex, with discrepancy among clinical providers and variation in the per cent of referrals for specialist care. To date, there is an increased focus on specialist referrals, risking overuse of expensive testing and contributing to unnecessary treatment. This report will considerer the difficulties of primary care musculoskeletal decision-making using shoulder injuries as an example, presenting a solution based on multi-criteria decision-making analysis with online software. The associated issues involved in clinical decision-making are complex. Contributing to the components of complexity are; the multifaceted aetiology of shoulders, the experience and knowledge of providers, and the burden of patient demands. Notwithstanding, funding considerations, resource allocation availability and other associated issues around clinical decision-making. Considering the many facets and complexities of clinical decision-making, this is an area where multi-criteria decision-making analysis (MCDM) may be appropriate. The MCDM analysis approach is increasingly being used in health care and can assist in the organizing and weighting of identified key clinical factors. MCDM could be applied to the challenges of musculoskeletal care with the potential to decrease decision-making variability. Furthermore, the significance of each key clinical factor that musculoskeletal decision-making is based on are to date unclear. Therefore, this preliminary report offers a start towards clarifying key factors and an approach for implementing improved shoulder clinical care decision-making which could then be adapted and applied to other body sites.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1159-1163Informations de copyright
© 2020 John Wiley & Sons Ltd.
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