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Using Judgment Analysis to Improve Prescribing Decisions of Physicians

Petra Denig
Groningen, The Netherlands

At the Department of Clinical Pharmacology, the Rational Drug Use group focuses on improving the prescribing behavior of doctors. Attention is given to the use of clinical judgment analysis as an educational tool.

In one project, the Drug Education Project, an educational program for peer groups was developed and tested. The program consists of providing individualized feedback about prescribing patterns, as well as on the underlying decision making process of the physician, based on clinical judgment analysis.

In a randomized controlled trial, the effectiveness of the educational program was tested on competence and performance in treating urinary tract infections (UTI) and asthma. Results of the asthma program, which was conducted in four different countries, have just been published in the American Journal of Respiratory and Critical Care Medicine (1999, 160, 1254-1262).

In another project, judgment analysis is used to study the decision criteria for the treatment of depression. Both general practitioners (GPs) and GPs in their vocational training are included as subjects. The aim of this study is to develop an educational tool for medical students, as well as practicing doctors, for teaching rational drug therapy for depression.

Also, we are working on a review of studies using cognitive feedback to improve the quality of treatment decisions of doctors. So far, however, it seems that most studies testing the effect of cognitive feedback on medical decision making either use students or focus on diagnostic, as opposed to prescribing, decision making.

Contact Petra Denig

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