title: Managing scientific uncertainty in medical decision making: the case of the advisory committee on immunization practices.
abstract: This article explores the question of how scientific uncertainty can be managed in medical decision making using the Advisory Committee on Immunization Practices as a case study. It concludes that where a high degree of technical consensus exists about the evidence and data, decision makers act according to a clear decision rule. If a high degree of technical consensus does not exist and uncertainty abounds, the decision will be based on a variety of criteria, including readily available resources, decision-process constraints, and the available knowledge base, among other things. Decision makers employ a variety of heuristic devices and techniques, thereby employing a pragmatic approach to uncertainty in medical decision making. The article concludes with recommendations for managing scientific uncertainty in medical decision making.
authors.affiliation: Kennesaw State University, Department of Political Science and International Affairs, 1000 Chastain Road, Kennesaw, Georgia 30144, USA. mike.martinez-corporatecounsel@dart.biz
authors.forename: J Michael
authors.initials: JM
authors.lastname: Martinez
mesh_terms: D026683:Advisory Committees / Q000941:ethics* / Q000458:organization & administration; D016265:Conflict of Interest; D003365:Costs and Cost Analysis; D003657:Decision Making / Q000941:ethics*; D003661:Decision Support Techniques; D026690:Ethics, Clinical; D006801:Humans; D007114:Immunization / Q000941:ethics*; D010686:Philosophy, Medical; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D035501:Uncertainty; D014481:United States