PMID: 754287Oct 1, 1978Paper

Clinical application of decision analysis: a detailed illustration

Seminars in Nuclear Medicine
S G Pauker, J P Kassirer

Abstract

The clinician must always optimize the patient's chance for the best possible outcome, but the complex task of deciding which diagnostic study to perform and which therapeutic agent to administer is usually carried out using imperfect information. These critical decisions are usually made in a covert fashion without explicit consideration of the multiple factors that impact on the outcome. Decision analysis is a quantitative method for making such diagnostic and therapeutic judgments, incorporating both probabilistic data and value judgments in the analysis of clinical problems. This article presents a brief overview of decision analysis and a detailed illustration of its use in an actual complex clinical situation. The clinical problem described consists of the management of suspected pulmonary embolism in a patient with a high risk of complications from both pulmonary arteriography and long-term anticoagulation. The example chosen also points up the virtue of decision analysis in considering prospectively both the information content and the attendant risks of contemplated diagnostic procedures.

References

Oct 1, 1978·Seminars in Nuclear Medicine·D D Patton
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Jul 1, 1976·Annals of Internal Medicine·S G Pauker
Jul 31, 1975·The New England Journal of Medicine·S G Pauker, J P Kassirer
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Citations

Jun 1, 1988·Journal of Critical Care·David C Thomasma
Oct 1, 1978·Seminars in Nuclear Medicine·L B Lusted
Oct 1, 1978·Seminars in Nuclear Medicine·D D Patton
Nov 1, 1988·The American Journal of Emergency Medicine·J P OrnatoE R Gonzalez
Aug 9, 2005·Journal of Biomedical Informatics·George C Scott, Ross D Shachter
Aug 3, 2010·Seminars in Nuclear Medicine·Dennis D Patton
May 15, 1980·The New England Journal of Medicine·S G Pauker, J P Kassirer
Dec 1, 1992·European Journal of Radiology·J CormackA M Tordoff
Jan 1, 1984·Medical Decision Making : an International Journal of the Society for Medical Decision Making·R A GreenesC B Begg
Jan 1, 1981·Medical Decision Making : an International Journal of the Society for Medical Decision Making·J E Gottlieb, S G Pauker
Jan 1, 1985·Medical Decision Making : an International Journal of the Society for Medical Decision Making·A S ElsteinL J Belzer
Jan 1, 1990·Medical Decision Making : an International Journal of the Society for Medical Decision Making·N F BoydB J Cummings
Aug 1, 1986·Quality Assurance and Utilization Review : Official Journal of the American College of Utilization Review Physicians·A F KriegM B Bongiovanni
Nov 1, 1981·Australasian Radiology·L M Dugdale
Sep 1, 1994·Journal of General Internal Medicine·A MorabiaA F Junod
Mar 1, 1991·Journal of Clinical Neuro-ophthalmology·M Stelmach, J O'Day
Jun 1, 1995·Diagnostic Cytopathology·S S RaabM B Cohen
Jun 6, 1998·Journal of Health Services Research & Policy·R Lilford, G Royston

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