Abstract
Most real-life decisions require the decision maker to make trade-offs in order to fulfill multiple conflicting objectives. This is especially true in medical decision making while selecting the optimal therapy plan from among competing therapy plans for a patient. Multi-attribute utility theory provides a framework to specify these trade-offs for optimal decision making based on the preferences of the decision maker. However traditional preference-assessment techniques are difficult to implement and rarely elicit the true preferences of the decision maker. We describe a new preference-assessment method based on the concept of knowledge maintenance where the preference model is changed each time it makes an incorrect recommendation. The method is implemented in a decision-theoretic system to evaluate competing three-dimensional radiation treatment plans. The preference-assessment method leads to preference models which perform better than preference models elicited using traditional assessment techniques.
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Selected References
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- Edwards G., Compton P., Malor R., Srinivasan A., Lazarus L. PEIRS: a pathologist-maintained expert system for the interpretation of chemical pathology reports. Pathology. 1993 Jan;25(1):27–34. doi: 10.3109/00313029309068898. [DOI] [PubMed] [Google Scholar]
- Farr B. R., Shachter R. D. Representation of preferences in decision-support systems. Comput Biomed Res. 1992 Aug;25(4):324–335. doi: 10.1016/0010-4809(92)90023-4. [DOI] [PubMed] [Google Scholar]
- Heckerman D. E., Horvitz E. J., Nathwani B. N. Toward normative expert systems: Part I. The Pathfinder project. Methods Inf Med. 1992 Jun;31(2):90–105. [PubMed] [Google Scholar]
- Kassirer J. P., Moskowitz A. J., Lau J., Pauker S. G. Decision analysis: a progress report. Ann Intern Med. 1987 Feb;106(2):275–291. doi: 10.7326/0003-4819-106-2-275. [DOI] [PubMed] [Google Scholar]
- Kutcher G. J., Leibel S. A., Mohan R., Harrison L. B., Armstrong J. G., Zelefsky M. F., LoSasso T. J., Burman C. M., Mageras G. S., Chui C. S. Advances in precision treatment: some aspects of 3D conformal radiation therapy. Front Radiat Ther Oncol. 1993;27:209–226. doi: 10.1159/000422094. [DOI] [PubMed] [Google Scholar]
- Miller R. A. Medical diagnostic decision support systems--past, present, and future: a threaded bibliography and brief commentary. J Am Med Inform Assoc. 1994 Jan-Feb;1(1):8–27. doi: 10.1136/jamia.1994.95236141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Purdy J. A., Harms W. B., Matthews J. W., Drzymala R., Emami B., Simpson J. R., Manolis J., Rosenberger F. U. Advances in 3-dimensional radiation treatment planning systems: room-view display with real time interactivity. Int J Radiat Oncol Biol Phys. 1993 Nov 15;27(4):933–944. doi: 10.1016/0360-3016(93)90471-7. [DOI] [PubMed] [Google Scholar]
- Rutledge G. W., Thomsen G. E., Farr B. R., Tovar M. A., Polaschek J. X., Beinlich I. A., Sheiner L. B., Fagan L. M. The design and implementation of a ventilator-management advisor. Artif Intell Med. 1993 Feb;5(1):67–82. doi: 10.1016/0933-3657(93)90006-o. [DOI] [PubMed] [Google Scholar]
- Seiver A. A decision class analysis of critical care life-support decision-making. Int J Clin Monit Comput. 1993 Feb;10(1):31–66. doi: 10.1007/BF01133524. [DOI] [PubMed] [Google Scholar]
