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Utility Structure of a Medical Decision-Making Problem

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  • Jeffrey P. Krischer

    (The Johns Hopkins University, Baltimore, Maryland)

Abstract

This paper investigates the utility structure of decision outcomes in the treatment of cleft lip and cleft palate. Utilities are assessed by questionnaire from 119 individuals representing 13 clinical specialties, as well as members of the families of cleft lip and palate children. The results of the survey demonstrate the validity of certain utility independence assumptions used to simplify the assessment of multiattribute utility functions. We found significant differences in utilities among clinicians, grouped according to their specialty and the treatment facility to which they are affiliated. Members of the families of cleft lip and palate children also differed with certain clinical specialty groups. The paper concludes with a discussion of the differences in the assessed utility functions and their implications for clinical decision making.

Suggested Citation

  • Jeffrey P. Krischer, 1976. "Utility Structure of a Medical Decision-Making Problem," Operations Research, INFORMS, vol. 24(5), pages 951-972, October.
    • Handle: RePEc:inm:oropre:v:24:y:1976:i:5:p:951-972
    DOI: 10.1287/opre.24.5.951
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    Cited by:

    1. Ralph L. Keeney, 1999. "The Value of Internet Commerce to the Customer," Management Science, INFORMS, vol. 45(4), pages 533-542, April.
    2. Gholamreza Torkzadeh & Gurpreet Dhillon, 2002. "Measuring Factors that Influence the Success of Internet Commerce," Information Systems Research, INFORMS, vol. 13(2), pages 187-204, June.
    3. Ralph L. Keeney & Robin S. Gregory, 2005. "Selecting Attributes to Measure the Achievement of Objectives," Operations Research, INFORMS, vol. 53(1), pages 1-11, February.
    4. Kwak, Seung-Jun & Yoo, Seung-Hoon & Kim, Tai-Yoo, 2001. "A constructive approach to air-quality valuation in Korea," Ecological Economics, Elsevier, vol. 38(3), pages 327-344, September.
    5. G. Anthony Gorry & Thelma Jean Goodrich, 1978. "On the Role of Values in Program Evaluation," Evaluation Review, , vol. 2(4), pages 561-572, November.
    6. Scott B. Cantor, 2004. "Clinical Applications in the Decision Analysis Literature," Decision Analysis, INFORMS, vol. 1(1), pages 23-25, March.
    7. Catherine Buron & Catherine Le Galès & Anne-Marie Fericelli, 1997. "L'indicateur QALYs à la lumière de la théorie de l'utilité espérée multi-attribut explicitement décomposée," Économie et Prévision, Programme National Persée, vol. 129(3), pages 55-71.
    8. Parton, Kevin A., 1979. "The Use Of A Decision Maker'S Utility Function In A Linear Programming Analysis Of Agricultural Policy," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 23(3), pages 1-13, December.
    9. Abraham Mehrez & Amiram Gafni, 1989. "Quality-adjusted Life Years, Utility Theory, and Healthy-years Equivalents," Medical Decision Making, , vol. 9(2), pages 142-149, June.

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