Skip to main content
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1983 Nov 15;129(10):1093–1099.

Interpretation of diagnostic data: 6. How to do it with more complex maths.

PMCID: PMC1875498  PMID: 6627168

Abstract

We have now shown you how to use decision analysis in making those rare, tough diagnostic decisions that are not soluble through other, easier routes. In summary, to "use more complex maths" the following steps will be useful: Create a decision tree or map of all the pertinent courses of action and their consequences. Assign probabilities to the branches of each chance node. Assign utilities to each of the potential outcomes shown on the decision tree. Combine the probabilities and utilities for each node on the decision tree. Pick the decision that leads to the highest expected utility. Test your decision for its sensitivity to clinically sensible changes in probabilities and utilities. That concludes this series of clinical epidemiology rounds. You've come a long way from "doing it with pictures" and are now able to extract most of the diagnostic information that can be provided from signs, symptoms and laboratory investigations. We would appreciate learning whether you have found this series useful and how we can do a better job of presenting these and other elements of "the science of the art of medicine".

Full text

PDF
1093

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Diamond G. A., Forrester J. S. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979 Jun 14;300(24):1350–1358. doi: 10.1056/NEJM197906143002402. [DOI] [PubMed] [Google Scholar]
  2. Kassirer J. P., Pauker S. G. The toss-up. N Engl J Med. 1981 Dec 10;305(24):1467–1469. doi: 10.1056/NEJM198112103052409. [DOI] [PubMed] [Google Scholar]
  3. Kassirer J. P. The principles of clinical decision making: an introduction to decision analysis. Yale J Biol Med. 1976 May;49(2):149–164. [PMC free article] [PubMed] [Google Scholar]
  4. McNeil B. J., Pauker S. G. The patient's role in assessing the value of diagnostic tests. Radiology. 1979 Sep;132(3):605–610. doi: 10.1148/132.3.605. [DOI] [PubMed] [Google Scholar]
  5. Pauker S. G., Kassirer J. P. Clinical application of decision analysis: a detailed illustration. Semin Nucl Med. 1978 Oct;8(4):324–335. doi: 10.1016/s0001-2998(78)80018-x. [DOI] [PubMed] [Google Scholar]
  6. Pauker S. G., Kassirer J. P. The threshold approach to clinical decision making. N Engl J Med. 1980 May 15;302(20):1109–1117. doi: 10.1056/NEJM198005153022003. [DOI] [PubMed] [Google Scholar]
  7. Ransohoff D. F., Feinstein A. R. Editorial: Is decision analysis useful in clinical medicine? Yale J Biol Med. 1976 May;49(2):165–168. [PMC free article] [PubMed] [Google Scholar]
  8. Schwartz W. B. Sounding board. Decision Analysis: a look at the chief complaints. N Engl J Med. 1979 Mar 8;300(10):556–559. doi: 10.1056/NEJM197903083001011. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES