Applying principles from the game theory to acute stroke care: Learning from the prisoner's dilemma, stag-hunt, and other strategies

Abstract

Background: Acute stroke care represents a challenge for decision makers. Decisions based on erroneous assessments may generate false expectations of patients and their family members, and potentially inappropriate medical advice. Game theory is the analysis of interactions between individuals to study how conflict and cooperation affect our decisions.

Aims: We reviewed principles of game theory that could be applied to medical decisions under uncertainty.

Summary: Medical decisions in acute stroke care are usually made under constrains: short period of time, with imperfect clinical information, limit understanding about patients and families' values and beliefs. Game theory brings some strategies to help us manage complex medical situations under uncertainty. For example, it offers a different perspective by encouraging the consideration of different alternatives through the understanding of patients' preferences and the careful evaluation of cognitive distortions when applying 'real-world' data. The stag-hunt game teaches us the importance of trust to strength cooperation for a successful patient-physician interaction that is beyond a good or poor clinical outcome.

Conclusions: The application of game theory to stroke care may improve our understanding of complex medical situations and help clinicians make practical decisions under uncertainty.

Keywords: Acute stroke therapy; decision making; decision neuroscience; endovascular; game theory; neuroeconomics; outcomes; prevention; prisoners’ dilemma.