La comorbidità e l'agire medico: il caso degli ipotrattamenti nella cura del tumore della mammella.

Translated title of the contribution: Comorbidity and the physician's decision: the case of undertreatment in care of breast tumors

G. Bertolini, G. Apolone, A. Liberati, S. Marsoni, N. Scarpiglione

Research output: Contribution to journalArticle

Abstract

When a physician has to come to a decision while caring for a given patient, he is supposed to take into account several kind of information related to the disease, illness or patients' personal characteristics. Although it is wellknown that the framework in which such decision has to be taken is complex, most of the scientific knowledge is based on pieces of evidence that derive from studies where complexity is avoided by applying restriction rules. The goal of this approach is to enhance the internal validity while preserving the generalizability of the findings. But in some cases this approach raises more doubts than certainty. It is the case of the process to assemble practice guidelines to reduce the gap between the best care and what is observed into practice using the available knowledge (i.e., available literature or experts' recommendations). As a variety of relevant clinical and patients' personal characteristics are not available at all or little is known on their impact on patients global health status, variables that actually do drive the practice are not included in guidelines that are intended to change it. This paper introduces the conceptual model of such debate and assesses the impact of co-morbidity--a variable seldom taken into account in effectiveness, quality and appropriateness studies- on the kind of medical care given to a sample of 1019 patients with early stage breast cancer. Empirical results and future implications are eventually discussed.

Original languageItalian
Pages (from-to)56-64
Number of pages9
JournalEpidemiologia e prevenzione
Volume18
Issue number58
Publication statusPublished - Mar 1994

Fingerprint

Comorbidity
Breast Neoplasms
Physicians
Practice Guidelines
Health Status
Guidelines
Morbidity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

La comorbidità e l'agire medico : il caso degli ipotrattamenti nella cura del tumore della mammella. / Bertolini, G.; Apolone, G.; Liberati, A.; Marsoni, S.; Scarpiglione, N.

In: Epidemiologia e prevenzione, Vol. 18, No. 58, 03.1994, p. 56-64.

Research output: Contribution to journalArticle

@article{a248c96c537d446da089262d8357d8af,
title = "La comorbidit{\`a} e l'agire medico: il caso degli ipotrattamenti nella cura del tumore della mammella.",
abstract = "When a physician has to come to a decision while caring for a given patient, he is supposed to take into account several kind of information related to the disease, illness or patients' personal characteristics. Although it is wellknown that the framework in which such decision has to be taken is complex, most of the scientific knowledge is based on pieces of evidence that derive from studies where complexity is avoided by applying restriction rules. The goal of this approach is to enhance the internal validity while preserving the generalizability of the findings. But in some cases this approach raises more doubts than certainty. It is the case of the process to assemble practice guidelines to reduce the gap between the best care and what is observed into practice using the available knowledge (i.e., available literature or experts' recommendations). As a variety of relevant clinical and patients' personal characteristics are not available at all or little is known on their impact on patients global health status, variables that actually do drive the practice are not included in guidelines that are intended to change it. This paper introduces the conceptual model of such debate and assesses the impact of co-morbidity--a variable seldom taken into account in effectiveness, quality and appropriateness studies- on the kind of medical care given to a sample of 1019 patients with early stage breast cancer. Empirical results and future implications are eventually discussed.",
author = "G. Bertolini and G. Apolone and A. Liberati and S. Marsoni and N. Scarpiglione",
year = "1994",
month = "3",
language = "Italian",
volume = "18",
pages = "56--64",
journal = "Epidemiologia e prevenzione",
issn = "1120-9763",
publisher = "Zadig s.r.l",
number = "58",

}

TY - JOUR

T1 - La comorbidità e l'agire medico

T2 - il caso degli ipotrattamenti nella cura del tumore della mammella.

AU - Bertolini, G.

AU - Apolone, G.

AU - Liberati, A.

AU - Marsoni, S.

AU - Scarpiglione, N.

PY - 1994/3

Y1 - 1994/3

N2 - When a physician has to come to a decision while caring for a given patient, he is supposed to take into account several kind of information related to the disease, illness or patients' personal characteristics. Although it is wellknown that the framework in which such decision has to be taken is complex, most of the scientific knowledge is based on pieces of evidence that derive from studies where complexity is avoided by applying restriction rules. The goal of this approach is to enhance the internal validity while preserving the generalizability of the findings. But in some cases this approach raises more doubts than certainty. It is the case of the process to assemble practice guidelines to reduce the gap between the best care and what is observed into practice using the available knowledge (i.e., available literature or experts' recommendations). As a variety of relevant clinical and patients' personal characteristics are not available at all or little is known on their impact on patients global health status, variables that actually do drive the practice are not included in guidelines that are intended to change it. This paper introduces the conceptual model of such debate and assesses the impact of co-morbidity--a variable seldom taken into account in effectiveness, quality and appropriateness studies- on the kind of medical care given to a sample of 1019 patients with early stage breast cancer. Empirical results and future implications are eventually discussed.

AB - When a physician has to come to a decision while caring for a given patient, he is supposed to take into account several kind of information related to the disease, illness or patients' personal characteristics. Although it is wellknown that the framework in which such decision has to be taken is complex, most of the scientific knowledge is based on pieces of evidence that derive from studies where complexity is avoided by applying restriction rules. The goal of this approach is to enhance the internal validity while preserving the generalizability of the findings. But in some cases this approach raises more doubts than certainty. It is the case of the process to assemble practice guidelines to reduce the gap between the best care and what is observed into practice using the available knowledge (i.e., available literature or experts' recommendations). As a variety of relevant clinical and patients' personal characteristics are not available at all or little is known on their impact on patients global health status, variables that actually do drive the practice are not included in guidelines that are intended to change it. This paper introduces the conceptual model of such debate and assesses the impact of co-morbidity--a variable seldom taken into account in effectiveness, quality and appropriateness studies- on the kind of medical care given to a sample of 1019 patients with early stage breast cancer. Empirical results and future implications are eventually discussed.

UR - http://www.scopus.com/inward/record.url?scp=0028398475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028398475&partnerID=8YFLogxK

M3 - Articolo

C2 - 8039561

AN - SCOPUS:0028398475

VL - 18

SP - 56

EP - 64

JO - Epidemiologia e prevenzione

JF - Epidemiologia e prevenzione

SN - 1120-9763

IS - 58

ER -