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Decision analysis

Authors
Mark S Roberts, MD, MPP
Joel Tsevat, MD, MPH
Section Editor
Mark D Aronson, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Decision analysis is a quantitative evaluation of the outcomes that result from a set of choices in a specific clinical situation. With the exception of the word quantitative, this definition is no different from the clinical decision making process conducted by clinicians every day. When faced with a particular problem, clinicians develop an array of possible actions ranging from doing nothing, to obtaining more information by performing diagnostic tests, to recommending various therapeutic strategies. This process is often implicit and occurs in the context of internal algorithms and heuristics (mental shortcuts) that the clinician has developed and acquired over time. Decision analysis, by requiring a specific model structure and assessment of the various likelihoods and values of the outcomes, makes the decision process explicit and much more amenable to examination, discussion, and intellectual challenge.

Decision models are often used as an analytic tool to conduct cost-effectiveness analyses since decision analysis methodology can be used to find the expected value of most any outcome. Cost-effectiveness analysis is discussed separately. (See "A short primer on cost-effectiveness analysis".)

TYPES OF PROBLEMS APPROPRIATE FOR DECISION ANALYSIS

The range of clinical problems appropriate for decision analysis is vast. The two major requirements for its use include:

The problem focuses upon a specific decision that must be made

There is a tradeoff involved in the decision

                  

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Literature review current through: Nov 2016. | This topic last updated: Fri Jan 29 00:00:00 GMT+00:00 2016.
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