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Understanding clinical decision making in small animal practice
  1. Jean-Michel Vandeweerd
  1. Department of Veterinary Medicine, University of Namur, Namur, Belgium
  1. email: jean-michel.vandeweerd{at}

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IN veterinary medicine, as in human medicine, a great deal of time is spent making diagnostic, therapeutic and preventive decisions in a complex and uncertain environment. While the veterinarian’s primary responsibility is the welfare of their patients, they also need to involve the owners in decisions about their animals’ care and the financial costs of treatment. Meeting these different expectations can lead to conflict as they try to balance medical, ethical and business demands.1 To help avoid such conflict, increasing the use of evidence-based clinical decision making is required.2,3

Clinical decision making has been studied extensively in human medicine, and numerous tools have been developed to optimise the decision-making process, such as decision analysis, decision tables and decision trees.4–6 Many software programmes and internet-based maps or trees have also been proposed to provide decision support at the individual patient level.7,8

Similar tools have been described in veterinary medicine.9,10 However, few published studies have investigated the decision-making process in veterinary practice – although interesting theoretical models have been hypothesised for clinical reasoning.11

In human medicine, one decision-making model that has been widely accepted is the recognition-primed decision model.12,13 In this model, decision making can occur very quickly as part of a natural thinking process. An alternative decision-making method is based on critical thinking.14 Furthermore, there are indications that one key factor in selecting effective strategies for promoting the adoption of evidence-based practices is the …

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