Download PDF
Methods Inf Med 1974; 13(04): 197-203
DOI: 10.1055/s-0038-1636157
Original Article
Schattauer GmbH

Consequence Evaluation in Decision Analytic Models of Medical Screening, Diagnosis, and Treatment

Bewertung der Folgen in Analytischen Entscheidungsmodellen FÜr Medizinisches Screening, Diagnose und Behandlung
J. C. Hershey
1   From the Health Services Administration Program. Department of Community and Preventive Medicine, Stanford University School of Medicine
› Author Affiliations
Further Information

Publication History

Publication Date:
10 February 2018 (online)

    Permissions and Reprints

This paper examines the problem of assigning values, or utilities, to separate consequences in decision analytic models of medical screening, diagnosis, and treatment. Several important issues related to this problem are studied, and a number of methodologies proposed for various applications are reviewed in relation to these issues. Finally, suggestions for future research in this area are proposed.

In dieser Arbeit wird das Problem der Zuordnung von Werten oder Nutzen untersucht, um die Folgen in analytischen Entscheidmigsmodellen für medizinisches Screening, Diagnose und Behandlung zu unterscheiden. Mehrere wichtige auf dieses Problem bezogene Fragestellungen werden mitersucht, und eine Anzahl von für verschiedene Anwendungsgebiete vorgeschlagene Methoden werden in bezug auf diese Fragestellungen besprochen. Letztlich werden Vorschläge für die zukünftige Forschung auf diesem Sektor unterbreitet.

Key-Words

Medical Screening - Diagnosis - Therapy - Decision Analysis - Utility Theory

Schlüssel-Wörter

Reihenuntersuchungen - Diagnostik - Therapie - Entscheidungsmodelle - Nutzen-Theorie
 

  • References

  • 1 Betaque N. E, Gobey G. A. Automating Judgmental Decision Making for a Serious Medical Problem. Management So 17 1971; 421-434.
    PubMedGoogle Scholar
  • 2 Bickner R. E. Measurements and Indices of Health. Conference Series, Outcome Conference I and II, Methodology of Identifying, Measuring and Evaluating Outcomes of Health Service Programs, Systems and Subsystems. (California Center for Health Services Research and National Center for Health Services Research and Development 1969).
    PubMedGoogle Scholar
  • 3 Blumbebg M. S. Evaluating Health Screening Procedures. Operations Res 05 1957; 351-360.
    CrossrefPubMedGoogle Scholar
  • 4 Carlson J. AV. Valuation of Life Saving. (Unpublished Ph. D. Dissertation, Harvard University 1963).
    PubMedGoogle Scholar
  • 5 Collen M. F, Rubin L, Neyman J. et al. Automated Multiphasic Screening and Diagnosis. Amer. J. publ. Hlth 54 1964; 741-750.
    CrossrefPubMedGoogle Scholar
  • 6 Fanshel S, Bush J. W. A Health-Status Index and Its Application to Health-Services Outcomes. Operations Res 18 1970; 1021-1066.
    CrossrefPubMedGoogle Scholar
  • 7 Fishbtjrn P. C. Independence in Utility Theory with Whole Product Sets. Operations Res 13 1965; 28-45.
    CrossrefPubMedGoogle Scholar
  • 8 Fishburn P. C. Utility Theory. Management Sc 14 1968; 335-378.
    PubMedGoogle Scholar
  • 9 Flagle Ch. D. Decision Theoretical Comparison of Three Procedures of Screening for a Single Disease. In LeCam L. J, Neyman J. (Eds.): Proceed Fifth Berkeley Symp. Math. Statist. Probab. Vol. IV. 887-901 Berkeley and Los Angeles: Univ. of California Press; 1967
    Google Scholar
  • 10 Flagle Ch. D. Automated Multiphasic Health Testing and Services. Total Systems Analysis and Design. Meth. Inform. Med 10 1971; 201-206.
    PubMedGoogle Scholar
  • 11 Flagle Ch. D. A Threshold Method for Utility Estimation and Resolution of Conflict. In: Lawrence J. R. (Edit.): Operational Research and the Social Sciences. 399-408 London: Tavistock Publications; 1966
    Google Scholar
  • 12 Flagle Ch. D, Lechat M. F. Statistical Decision Theory and the Selection of Diagnostic and Therapeutic Procedures in Public Health. Actes 3. Conf. Internat. Recherche Operationelle. London: English Universities Press; 1964
    Google Scholar
  • 13 Gorby G. A, Barnett G. O. Experience with a Model of Sequential Diagnosis. Comput. biomed. Res 01 1968; 490-507.
    PubMedGoogle Scholar
  • 14 Gorby G. A, Babnett G. O. Sequential Diagnosis by Computer. J. Amer. med. Ass 205 1968; 141-146.
    CrossrefPubMedGoogle Scholar
  • 15 Ginsberg A. S. Decision Analysis in Clinical Patient Management with an Application to the Pleural-EPfusion Problem. Rand Report R-751-RC/NLM. (The Rand Corporation, July 1971).
    PubMedGoogle Scholar
  • 16 Ginsbebg A. S, Offensend F. L. An Application of Decision Theory to a Medical Diagnosis-Treatment Problem. IEEE Trans. Syst. Sc. Cybernet d 1968; 355-362.
    PubMedGoogle Scholar
  • 17 Gustafson D. H, Edwabds W, Philipps L. D. et al. Subjective Probabilities in Medical Diagnosis. IEEE Trans. Man-Machine Sys 10 1969; 61-65.
    PubMedGoogle Scholar
  • 18 Henschke U. K, Fleeinger B. J. Decision Theory in Cancer Therapy. Cancer 20 1967; 1819-1826.
    CrossrefPubMedGoogle Scholar
  • 19 Hebshey J. C. A Decision Theoretic Analysis of Medical Screening Procedures. (Unpublished Ph. D. Dissertation, Stanford University 1970).
    PubMedGoogle Scholar
  • 20 Hobvath W. J. Operations Research in Medical and Hospital Practice. In Morse J. R. P. M. (Edit.): Operations Research for Public Systems. 127-157 Cambridge, Mass: The M. I. T. Press; 1967
    Google Scholar
  • 21 Lechat M. F, Flagle Ch. D. Allocation of Medical and Associated Resources to the Control of Leprosy. In Barish N, Verhulst M. (Eds): Management Sciences in the Emerging Countries. London: Pergamon Press; 1965
    Google Scholar
  • 22 Ledley R. S, Lusted L. B. Mathematical Models in Medical Diagnosis. J. med. Educat 35 1960; 214-222.
    PubMedGoogle Scholar
  • 23 Ledley R. S, Lusted L. B. Reasoning Foundation of Medical Diagnosis. Science 130 1959; 9-21.
    CrossrefPubMedGoogle Scholar
  • 24 Ledley R. S, Lusted L. B. The Use of Electronic Computers in Medical Data Processing. IRE Trans, med. Electron 07 1960; 31-47.
    PubMedGoogle Scholar
  • 25 Lodwick G. S. Computer Aided Diagnosis in Radiology: A Research Plan. Investigat. Radiol 01 1966; 72-80.
    CrossrefPubMedGoogle Scholar
  • 26 Lodwicic G. S. A Probabilistic Approach to the Diagnosis of Bone Tumors. Radiol. Clin. North America 03 1965; 487-497.
    PubMedGoogle Scholar
  • 27 Lodwick G. S, Turner A. H, Lusted L. B. et al. Computer Aided Analysis of Radiographic Images. J. chron. Dis 19 1966; 485-496.
    CrossrefPubMedGoogle Scholar
  • 28 Lusted L. B. Introduction to Medical Decision Making. Springfield, III: Charles C. Thomas; 1965
    Google Scholar
  • 29 Lusted L. B. Logical Analysis in Medical Diagnosis. In LeCam L. M, Neyman J. (Eds): Proceed. Fifth Berkeley Symp. Math. Statist. Probab. Vol. IV. 903-923 Berkeley and Los Angeles: University of California Press; 1967
    Google Scholar
  • 30 Overall J. E, Williams C. E. Conditional Probability Program for Diagnosis of Thyroid Function. J. Amer. med. Ass 1S3 1963; 307-313.
    PubMedGoogle Scholar
  • 31 Raiffa H. Decision Analysis: Introductory Lectures on Choices under Uncertainty. (Reading, Menlo Park, London, and Don Mills: Addison-Wesley 1968).
    PubMedGoogle Scholar
  • 32 Raiffa H. Preferences for Multi-Attributed Alternatives. Rand Report RM-5868-D0T/RC. (The Rand Corporation, April 1969).
    PubMedGoogle Scholar
  • 33 Reale A, Maccacaro G. A, Rocca E. et al. Computer Diagnosis of Congenital Heart Disease. Comput. biomed. Res 01 1968; 533-549.
    CrossrefPubMedGoogle Scholar
  • 34 Rubel R. A. Decision Analysis in Medical Diagnosis and Treatment. (Unpublished Doctoral Dissertation, Harvard University 1967).
    PubMedGoogle Scholar
  • 35 Rubin L, Collen M. F, Goldman G. E. Frequency Decision Theoretical Approach to Automated Medical Diagnosis. In LeCam L. M, Neyman J. (Eds): Proceed. Fifth Berkeley Symp. Math. Statist. Probab. Vol. IV. 867-886 Berkeley and Los Angeles: University of California Press; 1967
    Google Scholar
  • 36 Sasuly R, Ward PD. Two Approaches to Health Planning: The Ideal vs. the Pragmatic. Med. Care 07 1969; 235-241.
    CrossrefPubMedGoogle Scholar
  • 37 Scheff T. J. Decision Rules, Types of Errors, and Their Consequences in Medical Diagnosis. Behav. Sc 05 1933; 97-107.
    PubMedGoogle Scholar
  • 38 Schelling T. C. The Life You Save May Be Your Own. In Chase BSamuel. (Edit.): Problems in Public Expenditure Analysis. 127-176 Washington, D. C: Brookings Institution; 1938
    Google Scholar
  • 39 Stirison D. H. Utility Measurement in Public Health Decision Making. Management Sc 16 1969; 17-30.
    PubMedGoogle Scholar
  • 40 Toronto A. F, Warner H. et al. Evaluation of a Computer Program for Diagnosis of Congenital Heart Disease. Progr. cardiovas. Dis 05 1963; 362-377.
    CrossrefPubMedGoogle Scholar
  • 41 U. S. Department of Health, Education and Welfare, PHS, National Center for Health Statistics: Conceptual Problems in Developing an Index of Health, Vital and Health Statistics, PHS Publ. No. 1000, Series 2, No. 17. Washington, D. C: Government Printing Office; 1966
  • 42 Warner H. R, Toronto A. F, Veasey L. G. et al. Experience with Bayes’ Theorem for Computer Diagnosis of Congenital Heart Disease. Ann. N. Y. Acad. Sc 115 1964; 55S-567.
    PubMedGoogle Scholar
  • 43 Warner H. R, Toronto A. F, Veasey L. G. et al. A Mathematical Approach to Medical Diagnosis. J. Amer. med. Ass 177 1901; 177-1S3.
    PubMedGoogle Scholar