Decision analysis for the practicing gastroenterologist. 1. Reading a decision analysis paper
Smith, J.L.
American Journal of Gastroenterology 80(6): 490-492
1985
ISSN/ISBN: 0002-9270 PMID: 4003380 Document Number: 245798
To emphasize, clinical decision analysis rests on logic structures and data, all of which must be derived clinically. There are three reasons to dispute the conclusions of an exercise. The reader may dispute the logic (the construct of the decision tree), challenge the data that was utilized for the decision tree, or be unjustly stubborn. What is the role of decision analysis? It is a formal exposition of some of the subprocesses of medical reasoning, and it may serve as a check on the consistency of current medical practice, or be an excellent educational tool. By isolating the critical data needed for decisions, it can direct research or study. It is not, however, a full imitation of clinical judgment (it is usually too limited in both scope and data) and is not yet a primary guide to patient care, although it has been used, on a regular basis to examine care (e.g., Reference 2). When data are well justified for each node, and when the individual clinician utilizes sensitivity analysis to adjust for his own locale, then perhaps it can be a usual aid in clinical decision making. Until then, the current applications are too limited in scope and are confounded by the same variably adequate data that we presently deal with.