Clinical decision analysis: Incorporating the evidence with patient preferences

Ilyas S Aleem1, Hamza Jalal2, Idris S Aleem3, Adeel A Sheikh1, Mohit Bhandari11Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 2The University of Calgary, Calgary, Alberta, Canada; 3Carleton University, Ottawa, Ontario, CanadaAbstract: Decision analysis has become an increasingly popular decision-making tool with a multitude of clinical applications. Incorporating patient and expert preferences with available literature, it allows users to apply evidence-based medicine to make informed decisions when confronted with difficult clinical scenarios. A decision tree depicts potential alternatives and outcomes involved with a given decision. Probabilities and utilities are used to quantify the various options and help determine the best course of action. Sensitivity analysis allows users to explore the uncertainty of data on expected clinical outcomes. The decision maker can thereafter establish a preferred method of treatment and explore variables which influence the final clinical outcome. The present paper reviews the technique of decision analysis with particular focus on its application to clinical decision making.Keywords: decision analysis, patient preference, game theory, evidence-based medicine