Improving Clinical Guidelines and Decisions Under Uncertainty

65 Pages Posted: 9 Oct 2017

See all articles by Charles F. Manski

Charles F. Manski

Northwestern University - Department of Economics; National Bureau of Economic Research (NBER)

Date Written: October 2017


This paper discusses how limited ability to assess patient risk of illness and predict treatment response may affect the welfare achieved by adherence to clinical practice guidelines and by decentralized clinical practice. I explain why predictive ability has been limited, calling attention to imperfections in clinical judgment and to questionable methodological practices in the research that supports evidence-based medicine. I discuss recent econometric research that can improve the ability of guideline developers and clinicians to predict patient outcomes. Recognizing that uncertainty will continue to afflict medical decision making, I apply basic decision theory to suggest reasonable decision criteria with well-understood welfare properties.

Suggested Citation

Manski, Charles F., Improving Clinical Guidelines and Decisions Under Uncertainty (October 2017). NBER Working Paper No. w23915, Available at SSRN:

Charles F. Manski (Contact Author)

Northwestern University - Department of Economics ( email )

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