Systematic approach: an evidence management strategy for better decision-making

Area of Science:

• Medical Decision Making
• Evidence-Based Medicine
• Systems Science

Background:

• Evidence-based medicine prioritizes evidence but often neglects systematic decision-making processes.
• Medical decisions involve analyzing evidence for specific actions, a process improvable through systematic approaches.

Purpose of the Study:

• To propose a systematic loop model for medical decision-making.
• To enhance the reliability and structure of evidence-based medicine.
• To identify research gaps and prioritize future studies.

Main Methods:

• Developed a schematic systematic loop based on four traditional medical steps (nosology, semeiology, pathophysiology, therapy) and their transitions.
• Evaluated steps by reproducibility and transitions by predictability.
• Formulated eight basic questions to test the reliability of the decision-making loop.

Main Results:

• Applied the systematic loop approach to the EPHESUS study.
• Demonstrated the model's utility in controlling medical knowledge and identifying evidence gaps.
• Showcased how the systematic approach structures evidence for improved decision-making.

Conclusions:

• A systematic approach is crucial for structuring evidence in medicine.
• The proposed loop model enhances the reliability of medical decisions.
• This framework aids in identifying research priorities for evidence-based medicine.