The Science and Art of Mapping Risk-Benefit Analyses in Clinical Decision Making

Abstract

In order to consistently provide high quality patient care, pharmacists must make critical decisions multiple times per day.  Pharmacists often unconsciously incorporate risk-benefit analyses when making clinical decisions.  This article provides a comprehensive template for pharmacists and other healthcare practitioners to use when assessing risks and benefits of drug therapy.  First, the clinician must define risks and benefits.  The practitioner then quantifies the likelihood that an event will occur and grades the evidence that supports these probability estimates.  This systematic and thorough approach to balancing risks and benefits may allow clinicians to more definitively make appropriate decisions about drug therapy.  Examples are given where a pharmacist is likely to change his/her decision if the definition, likelihood or level of evidence varies.  Many pharmacists likely use a similar process when caring for patients, but have not deliberately represented the process in algorithmic form.  However, after outlining the process in practice on a daily basis, a pharmacist will come to realize the value of human judgment in clinical decision making.