Medical decision making : an international journal of the Society for Medical Decision Making
-
To estimate the cost-effectiveness of universal childhood rotavirus vaccination in Belgium, taking into account the impact of caregiver burden and the burden of sick children for whom no medical care is sought ("no medical care'' ). ⋯ For the Belgian health care payer, at current vaccine prices, universal childhood rotavirus vaccination is unlikely to be judged cost-effective versus no vaccination but would be a more efficient and equitable choice than continuing with current practice.
-
Decisional conflict is defined as personal uncertainty about which course of action to take when choice among competing options involves risk, regret, or challenge to personal life values. It is influenced by inadequate knowledge, unclear values, inadequate support, and the perception that an ineffective decision has been made. Until recently, it has been studied at the individual level, which ignores the interpersonal system between patients and physicians. ⋯ Personal uncertainty of patients and physicians is influenced not only by their respective deficits but also by the deficits of the other member of the dyad. Our results indicate that the more unclear the expression of their own values and the more they perceive that an ineffective choice had been made, the more both physicians and patients experience personal uncertainty. They also indicate that the less uninformed they feel, the more both physicians and patients experience personal uncertainty.