Decision Analysis

Lead Author(s): Clay Johnston, MD, PhD

Decision analysis is an explicit, quantitative method for making (or at least thinking about) decisions in the face of uncertainty. In decision analysis, uncertainty is quantified using probabilities, and the desirability of outcomes is quantified using utilities. Then the expected utility of each alternative course of action (weighting utilities of different outcomes by their probabilities) is calculated, and the one that on average will lead to outcomes considered most desirable can be chosen.

Decision analysis and cost-effectiveness research are useful for difficult decisions where there is uncertainty about outcomes of alternative courses of action.

These situations include:
  1. For developing policies, treatment guidelines, etc.
  2. At the bedside (i.e. helping individual patients to make decisions).
  3. To help focus discussion and identify important areas for further research.
  4. In your life outside of medicine.
  5. As a teaching tool to discourage dogmatism and to demonstrate rigorously the need to involve patients in decisions.