Toma de decisiones en la práctica clínica: Propuesta de un enfoque basado en evidencia “4E”

Translated title of the contribution: Decision-making in clinical practice: "4E" evidence-based framework proposal

Carlos Alva-Diaz, Victor Velásquez-Rimachi, Joel Sequeiros, Kevin Pacheco-Barrios

Research output: Contribution to journalArticlepeer-review


Background: Human decisions are partially rational. In medicine, critical scenarios make decide-making (DM) difficult. In this review, we propose the "4E" approach to improve the DM of interventions. The "4E" approach includes decisions: "effectual" when interventions have been tested in controlled settings, "effective" when interventions have been tested in uncontrolled or pragmatic clinical settings, "efficient" when the benefits of a new intervention are evaluated by its costs, and decisions that promote "equity" when these interventions are recommended according to the needs of the patient, avoiding barriers. Using this approach could improve DM in clinical practice, but it is not enough to guarantee its incorporation and use. It is also essential to promote the organizational, institutional, and political dynamics of health systems that promote evidence's critical use to make decisions.

Translated title of the contributionDecision-making in clinical practice: "4E" evidence-based framework proposal
Original languageSpanish
Pages (from-to)86-90
Number of pages5
JournalRevista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo
Issue number1
StatePublished - 1 Jan 2022


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