Kelsey J V, Beck J R
Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire.
J Cancer Educ. 1990;5(2):125-34. doi: 10.1080/08858199009528050.
Decision analysis is a formal approach to clinical decision making in the setting of uncertainty. Computer assisted clinical decision analysis was used at tumor board to help examine difficult oncological cases. Patients were identified early in the week and the decisions, possible outcomes, and uncertainties of each decision were modeled. These models were then presented at tumor board where the calculated expected utilities of each decision could be discussed. A description of decision analysis and three representative cases are presented here. These exercises were valuable for at least two reasons. First, modeling the problems confronting practicing oncologists was instructive as such. Second, the mathematical treatment of the probabilities and the utilities of the various outcomes for each decision stimulated a lively debate among the board members, forcing them to quantify probabilities and outcomes that they had previously ascertained qualitatively.
决策分析是在存在不确定性的情况下进行临床决策的一种正式方法。在肿瘤病例讨论会上使用计算机辅助临床决策分析来帮助审查疑难肿瘤病例。在一周的早些时候确定患者，并对每个决策的决策内容、可能结果和不确定性进行建模。然后在肿瘤病例讨论会上展示这些模型，在会上可以讨论每个决策计算出的期望效用。本文介绍了决策分析的描述以及三个典型案例。这些实践至少有两个方面的价值。首先，对执业肿瘤学家面临的问题进行建模本身就具有启发性。其次，对每个决策的各种结果的概率和效用进行数学处理，激发了委员会成员之间的热烈辩论，迫使他们对之前定性确定的概率和结果进行量化。
