Diagnosis, followed by effective interventions to achieve outcomes desired by the patient lie at the heart of medical practice. Clinicians do this every day, yet do not make their processes explicit. The probabilities of achieving different outcomes can be ascertained from the research literature. The value attached to the outcomes is, of course, a matter for the patient, but can also be measured.
This book (published in 1993) explains how clinical decision analysis breaks down the processes of decision making into component parts, so that it can be seen how different probabilities of reaching defined outcomes and different patient values placed on those outcomes determine the expected value of different clinical actions.
Each chapter considers the topic using the same illustrated case sample, a patient with a transient ischaemic attack. The chapters illustrate how to set up a decision tree, and the effect of varying the probabilities and utilities upon the expected value of different interventions. The book will be a useful text for all those clinicians who wish to consider in more detail how they reach clinical decisions and how they can make these decisions more explicit and robust. It will also be of interest to all those engaged in health informatics, economics, computing and statistics.
Copies available on request.