Clinical decision analysis.

Abstract

This condensed review of a complex method can provide only a general view of what clinical decision analysis is and why it might be useful. It also should help clarify, however, what decision analysis is not: This is not a practical method for making most decisions in everyday clinical practice. The process of carrying out all the steps in a full, formal analysis is much too time consuming to be applied to the dozens of important decisions clinicians make each day. The method should be used selectively to ensure that the time invested in analysis will pay off in a practical way in practice. Formal analyses should be attempted only for decisions that are made frequently, have important consequences, and provoke some sort of significant controversy, uncertainty, or discontent with the results less formal-decision making achieves. Decision analysis is not a substitute for all other methods of decision making. To suggest that this is the only tool clinicians need would be a little like suggesting that a balanced diet could consist exclusively of broccoli. Intuitive judgments, use of theoretical models, knowledge-problem coupling, and hypothesis-oriented algorithms for clinicians all provide important tools for improving patient care. Often these tools can be combined effectively with decision analysis, but at other times they will be superior on their own. Decision analysis is not an entirely unfamiliar method, and it does not always need to include all component steps to be useful.(ABSTRACT TRUNCATED AT 250 WORDS)