Clinical decision making — an application of judgment analysis and its potential for pharmacy

Abstract

Abstract Objectives To explore the methodological use of judgment analysis in understanding clinical decision-making among United Kingdom(UK) general practitioners (GPs), and to consider how it might be applied to pharmacy. Method Written cases, with clinical and social patient information, were developed for sore throat and dyspepsia. Decision models were created relating social and clinical information to: (1) GPs' perceptions of severity (sore throat); (2) the likelihood of an ulcer diagnosis (dyspepsia). Setting Two counties in southern England. Key findings Of the 47 practices contacted, 17 (36 per cent) participated with 24 general practitioners completing the sore throat series and 24 different GPs completing the dyspepsia series. Twenty GPs (42 per cent) had decision models incorporating social factors. These GPs were no more likely to prescribe on paper or in practice than those with decision models without social factors. Conclusion Judgment analysis has yet to be applied to the decision-making of practising pharmacists. Potential applications include pharmacists' decisionmaking in the area of minor ailment management or the decision when to intervene when monitoring prescriptions. The influence of social factors, such as patient demand, social class or a distressing patient circumstance on pharmacists' decision-making are aspects of decision-making particularly worthy of future investigation.