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Solid Recommendations from Soft Numbers

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  • Robert F. Nease JR.
  • Yann Bonduelle

Abstract

The authors review the probability threshold approach to test/treatment decisions developed by Pauker and Kassirer, 6,7 emphasizing that certain aspects of the nature of medical decisions call for a new approach. The utility threshold approach, while maintaining all the advantages of threshold methods in general, brings improvements. It diminishes the need to accurately assess one of the decision's parameters: the patient's utility for the outcome states. For a simple case of one disease with three outcome states (cured, diseased, dead) and one test, three utility thresholds are derived. The treat/no treat threshold, denoted by u*, separates the utility space in two. If the patient's value for the diseased state is greater than u*, the analyst can feel confident in recommending the patient forego treatment. Similar interpre tations are developed for u 1 , the no treatment/test utility threshold (the value u must take, given a positive test result, for the patient to be indifferent between foregoing and receiving treatment), and u 2 , the test/treatment utility threshold (the value u must take, given a negative test result, for the patient to be indifferent between foregoing and receiving treatment). Key words: medical decision analysis; threshold analysis; utility threshold. (Med Decis Making 7:220-233, 1987)

Suggested Citation

  • Robert F. Nease JR. & Yann Bonduelle, 1987. "Solid Recommendations from Soft Numbers," Medical Decision Making, , vol. 7(4), pages 220-233, December.
    • Handle: RePEc:sae:medema:v:7:y:1987:i:4:p:220-233
    DOI: 10.1177/0272989X8700700404
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    References listed on IDEAS

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    1. H. Llewellyn-Thomas & H.J. Sutherland & R. Tibshirani & A. Ciampi & J.E. Till & N.F. Boyd, 1982. "The Measurement of Patients' Values in Medicine," Medical Decision Making, , vol. 2(4), pages 449-462, December.
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