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a derivative of operations research and game theory that involves identifying all available choices and the potential outcomes of each, in a series of decisions that have to be made about patient care-diagnostic procedures, therapeutic regimens, prognostic expectations; the range of choices can be plotted on a decision tree.
decision analysisClinical decision analysis Decision making
1. An approach to decision making under conditions of uncertainty, involving modeling of sequences or pathways of multiple possible strategies–eg, of diagnosis and treatment for a particular clinical problem to determine which is optimal; DA is based on available estimates–drawn from the literature or from experts of the probabilities that certain events and outcomes will occur and the values of the outcomes that would result from each strategy. See Decision tree.
2. An analysis in which '…a problem is stated, assumptions concerning probabilities and utilities are made, and a conclusion is reached based on the results. If the reader (of the analysis) agrees with the structure, assumptions, and probabilities of the analysis, then he or she must agree with its conclusion.' See Algorithm, Critical pathway.
A logical, consistent approach to making a medical decision when its consequences cannot be foretold with certainty. Uncertainties in medical practice are due to many factors (e.g., biological variation and limitations in the clinical data available for an individual patient). There are three steps in the analysis: 1. the consequences of each option is described schematically by the use of a decision tree; 2. probability is used to quantify the uncertainties inherent in each option; and 3. each possible outcome is designated by a number that measures the patient's preference for that outcome as compared with the others. After the last step is completed, each outcome is assigned a “utility” value in which 1.0 indicates a perfect outcome and 0 is the worst possibility. Decision analysis may be used to help members of the health care team and the patient make logical choices concerning management of illness.
a choice between a number of possible answers to a question.
a systematic approach to decision making under conditions of imperfect knowledge; a practical application of probability theory. Used to calculate the optimal strategy from among a series of alternative strategies. May be expressed graphically in the form of a decision tree (below).
making a decision can be done in three principal ways and many variations and mixtures of the methods: (1) rote, the decision is made on the basis of a set of rules and no selectivity is required; (2) intuitive, decisions are made on the basis of cerebrally stored information and reasoning systems which permit a fast response. The increasing complexity of veterinary clinical questions increases the probability of error; (3) decision analysis, a means of solving complicated problems by including all of the factors that could possibly affect the outcome of the analysis in a series of sequential questions. This gives each of the factors an opportunity of affecting the outcome. The chance of error by omission can be eliminated but the process is prolonged.
the theoretical basis for decision analysis.
a diagrammatic representation of the possible outcomes and events used in decision analysis. The questions to be asked in an analysis of a question are arranged as a series of nodes each with a yes and no branch, creating an arborization effect. The sequential steps proceed with each step depending on the decision made in the preceding step.