Kent D L
Problem Evaluation Center, Seattle VA Medical Center, WA.
J Dent Educ. 1992 Dec;56(12):791-9.
Historically, decision analysis (DA) arose from economics, psychology, and statistics. Medical and dental applications have developed over the past two decades. While decision psychology explores how people make their decisions, the DA process involves construction of a model and development of insights into the strengths and uncertainties about recommendations derived from analysis of model outputs. Uncertainties are represented as probabilities and values are assigned to desirable or adverse outcomes according to preferences expressed by the decision maker. The model unifies probabilities and values by calculation of the expected value for each decision choice. The decision maker can improve his or her insight into uncertainties in the model by conducting sensitivity analyses, and can take action based on this improved insight. The DA process is illustrated using the decision to take or skip influenza vaccination. People's decision making behavior for this problem has also been analyzed using methods from decision psychology. Distinctions between clinical DA and cost-effectiveness analysis are given, as are caveats about especially complicated subtopics in decision analysis for medical problems. In closing, opportunities for further study of decision analysis are presented.
从历史上看，决策分析（DA）起源于经济学、心理学和统计学。医学和牙科领域的应用在过去二十年中得到了发展。决策心理学探讨人们如何做出决策，而决策分析过程则涉及构建模型，并深入了解从模型输出分析得出的建议的优势和不确定性。不确定性以概率表示，根据决策者表达的偏好为期望或不利结果赋予值。该模型通过计算每个决策选择的期望值来统一概率和值。决策者可以通过进行敏感性分析来提高对模型中不确定性的洞察力，并可以基于这种提高的洞察力采取行动。通过决定接种或不接种流感疫苗来说明决策分析过程。针对这个问题，人们的决策行为也使用决策心理学方法进行了分析。文中给出了临床决策分析与成本效益分析之间的区别，以及医学问题决策分析中特别复杂的子主题的注意事项。最后，还介绍了决策分析进一步研究的机会。
