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Failure of cost-benefit analysis in gastrointestinal endoscopy

机译:胃肠镜检查中成本效益分析的失败

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摘要

We discuss the occurrence of two cases, where the endoscopic pursuit of diagnostic certainty resulted in adverse events that exceeded the clinical relevance of the endoscopic diagnosis itself. In both instances, physicians were hesitant to subject their patients to a necessary surgical intervention before gastrointestinal endoscopy had provided them with absolute assurance that no other mitigating factors could possibly jeopardize the success of a planned intervention. In trying to avoid a single and potentially bad outcome of a necessary medical intervention, the physicians exposed their patients to many more additional and unnecessary risks. As key players in clinical decision-making, physicians sometimes may find it difficult to disentangle their own risk-benefit considerations from those of their patients.
机译:我们讨论了两种情况的发生,其中内窥镜对诊断确定性的追求导致不良事件超过了内窥镜诊断本身的临床意义。在这两种情况下,医生都不愿在胃肠道内窥镜检查之前向患者进行必要的手术干预,从而绝对确保没有其他缓解因素可能会危害计划中的干预措施的成功。为了避免必要医疗干预的单一结果和潜在的不良后果,医生使他们的患者面临更多更多和不必要的风险。作为临床决策的关键角色,医生有时可能会发现很难将自己的风险收益考虑因素与患者的考虑因素区分开。

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