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6 - Decision analysis in clinical neurology
from Part I - Quantitative methods in clinical neurology
- By Diederik W. J. Dippel
Albert Hofman, Erasmus Universiteit Rotterdam, Richard Mayeux, Columbia University, New York
Book:

Investigating Neurological Disease

Published online:

29 September 2009

Print publication:

30 August 2001, pp 52-69
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Summary

In the clinical neurosciences, decision making becomes more complicated every day, because of rapidly emerging new treatments and diagnostic tests, and because of increasing demands from patients to be informed and to participate in decision making. This chapter presents two outlines to illustrate the basic elements of a decision analysis. The first example concerns a diagnostic problem, and it is used to illustrate the modeling of a decision tree, the calculation of expected utility, and sensitivity analyses. In the second example, a therapeutic problem, quality adjusted survival analysis is introduced. An analysis of diagnostic and one of therapeutic decision making have been used to illustrate the key elements and methodology of clinical decision analysis in neurology. Although the results of a decision analysis can be helpful in clinical practice, the responsibility in clinical decision making will always remain with the clinician.