| Abstrakt: |
Decision making under conditions of uncertainty characterizes medical practice. Clinicians are constantly faced with decisions that have implications on potential benefits, risks, gains, and losses not only for the patients, but also for several different stakeholders. These stakeholders include patients, providers, hospitals, payors, and society. The challenge of clinical medicine is to account for many different possibilities under conditions of considerable uncertainty. Medical literature often provides focused evidence regarding particular clinical problems, but this constitutes only a portion of the information required to fully evaluate a decision (1-3). Decision analysis is a mathematical tool designed to facilitate complex clinical decisions in which many variables must be considered simultaneously. This analytical procedure selects among available diagnostic or therapeutic options based on the probability and predetermined value (utility) of all possible outcomes of those options. Decision analysis provides a systematic framework for organizing all data relevant to the decision, clearly defines the relationship between possible courses of action and their associated outcomes, and assigns a numerical value to various courses of action, simplifying comparisons between them. The role of decision analysis is to provide a systematic, nonbiased data review, which results in a suggested management strategy (4). Decision analysis provides an organized method in which all possible outcomes are considered, so that relevant uncertainties are less likely to be overlooked (5). By making the assumptions explicit decision analysis clarifies the management strategies. [ABSTRACT FROM AUTHOR] |
