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Decision making is a critical element in the field of medicine that can lead to life-or-death outcomes, yet it is an element fraught with complex and conflicting variables, diagnostic and therapeutic uncertainties, patient preferences and values, and costs. Judgments and decisions made daily in clinical work necessitate the assessment and management of risks. The physician must determine what may be wrong with a patient and recommend a prevention or treatment strategy, generally under less-than-optimal circumstances and time frames. A patient decides whether or not to follow this recommendation and, once under care, may or may not faithfully pursue a recommended strategy. Health policy makers and insurers must decide what to promote, what to discourage, and what to pay for. Together, such decisions determine the quality ...

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