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*There are three principles in decision making in medicine

The first is Knowing the patients true state is often unnecessary. This means a physician does not have to be absolutely sure about the diagnosis when starting treatment.

Second, Treatment error is always a possibility. This is especially true when we make decisions even with uncertainty.

Third, The need for diagnostic certainty depends on the penalty for being wrong. This means we want to make sure about our diagnosis if the harmful effect of the error is grave.

For example, in a patient with headache we dont have to requests for test if we are thinking of simple headache and we want to give the patient paracetamol. However if we are thinking of brain cancer as the cause of headache and we are recommending brain surgery, we need to request for more tests because we want to be sure if it is really brain cancer. The harm that will happen to the patient will be very grave if we subject him to brain surgery and the patient did not have brain cancer.

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