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. 2009 Dec;21(4):216-222.
doi: 10.1053/j.semss.2009.08.003.

Decision Analysis and Cost-effectiveness Analysis

Hilary F Ryder, Christine McDonough, Anna N A Tosteson, Jon D Lurie

Decision Analysis and Cost-effectiveness Analysis

Hilary F Ryder et al. Semin Spine Surg. 2009 Dec.

Abstract

Healthcare decision-making can be complex, often requiring decision makers to weigh serious trade-offs, consider patients' values, and incorporate evidence in the face of uncertainty. Medical decisions are made implicitly by clinicians and other decision-makers on a daily basis. Decisions based largely on personal experience are subject to many biases. Decision analysis and cost-effectiveness analysis are systematic approaches used to support decision-making under conditions of uncertainty that involve important trade-offs. These mathematical tools can provide patients, physicians and policy makers with a useful approach to complex medical decision making.

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Figures

Figure 1
Figure 1
A basic decision tree.
Figure 2
Figure 2
A simple decision tree for lumbar discectomy for a hypothetical patient with severe sciatica. p represents the probability of each outcome at the chance node and U represents the utility of each outcome.
Figure 3
Figure 3
A simple decision tree for lumbar discectomy for a hypothetical patient with mild sciatica. p represents the probability of each outcome at the chance node and U represents the utility of each outcome.
Figure 4
Figure 4
Results from a one-way sensitivity analysis where the utility for persistent sciatica is systematically varied from 0.6 to 1.0. Crossing lines indicate that a threshold health state utility for persistent sciatica exists. (Color version of figure is available online.)
See this image and copyright information in PMC

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