Multi-perspective (Treatment) Decisions
- John Svirbely
Description
The treatment decision pattern is a complex pattern that incorporates multiple sub-patterns. The goal is to capture an abstract decision on how to treat a patient, looking at the problem from the different perspectives of different agents.
This pattern is an extension of the Team-based Decision pattern, where multiple agents try to make the same decision from similar perspectives. In this pattern, each agent also makes the same decision from multiple perspectives.
Problem
Determining the optimal treatment for a patient involves multiple agents making multiple sub-decisions that feed into the ultimate therapeutic decision. A clinician may consider the decision from a population perspective (what is the best treatment for patients like this one, based on population studies?), from the medical perspective for the individual patients (what is the optimal treatment for this patient, given demographic factors and comorbidities?), and from the socioeconomic perspective (what is the optimal treatment for this patient given the socioeconomic context?).
Eventually, clinician and patient collaboratively make the final decision.
Applicability
· This is the same as a Team-based decision.
· A decision can be made from different perspectives P1, .. Pn
o Given a fixed set of inputs, the outcome of the decision from perspective Pj is possibly different than the outcome of the same decision from perspective Pk
Pattern
Figure 1 – Multi-perspective (Treatment) Decision Pattern
Model the top-level treatment decision with two sub-decisions with the same question and possible answers: one with the patient as the decision-maker, the other with the clinician as the decision-maker. The clinician's treatment decision, in turn, has three sub-decisions made from multiple perspectives: The population-based decision which considers the evidence-based guideline; the medically individualized decision, which considers patient-specific factors (e.g., comorbidities); and the socioeconomically individualized decision, which incorporates factors such as support systems, cultural considerations, and financial capacity.
v Note that other patterns may apply. For example, the population-based treatment decision may be informed by a CDS intervention that, in turn, provides some sort of recommendation based on a quantitative scoring model.
Specific Example
Figure 2 – Multi-perspective (Treatment) Decision Pattern
Metadata
Discussion
Related Patterns
