Why do thoracic surgeons need training in decision making? Many of us who have
weathered harrowing residencies in surgery feel that, after such experiences, decision
making is a natural extension of our selves. While this is no doubt true, correct decision making is something that many of us have yet to master. The impetus to develop
a text on evidence-based decision making in thoracic surgery was stimulated by a
conference for cardiothoracic surgical trainees developed in 2004 and sponsored by
the American College of Chest Physicians. During that conference it became clear that
we as thoracic surgeons are operating from a very limited fund of true evidence-based
information. What was also clear was the fact that many of the decisions we make in
our everyday practices are not only uninformed by evidence-based medicine, but often
are contradictory to existing guidelines or evidence-based recommendations.
The objectives of this book are to explain the process of decision making, both on
the part of the physician and on the part of the patient, and to discuss specific clinical
problems in thoracic surgery and provide recommendations regarding their management using evidence-based methodology. Producing a text that will purportedly guide
experienced, practicing surgeons in the decision-making process that they are accustomed to observe on a daily basis is a daunting task. To accomplish this it was necessary
to assemble a veritable army of authors who are widely considered to be experts in their
fields. They were given the unusual (to many of them) task of critically evaluating evidence on a well-defined topic and provide two opinions regarding appropriate management of their topic: one based solely on the existing evidence, and another based on
their prevailing practice, clinical experience, and teaching. Most authors found this to
be an excellent learning experience. It is hoped that the readers of this book will be
similarly enlightened by its contents.
Download here: Difficult Decisions in Thoracic Surgery
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