Management Of Risk And Decision Analysis Flashcards
How is decision analysis performed?
Decision analysis involves the understanding of a decision task by dividing it into components using decision trees that can suggest the most appropriate decision for a situation. Decision analysis is based on the normative theory of subjective expected utility theory.
What is normative theory?
Based on the population or the consensus of the majority.
What is subjective expected utility theory?
Assumes that the decision process is logical and rational and that a rational decision maker will choose the choice that maximises health.
What does the square represent in decision analysis?
Decision choice.
What does the circle represent in decision analysis?
The outcomes/event.
What should decisions be based on?
Evidence generated by research from:
Effectiveness via RCTs
Prognosis via RCTs or cohort studies
Why is decision analysis important?
Suggests the most appropriate decision for a particular situation
Assists in understanding of a decision
Uses decision trees to structure a task
Divides decision task into separate components
What are the stages of decision analysis?
->Structure of the problem as a decision tree
->Assess the probability of each branch
->Calculate the utility of each outcome state
->Select the option with the most expected utility
->Conduct a sensitivity analysis to assess the effect of varying judgement.
What is important in the construction of a decision tree?
It should be structured with the use of a subject expert. There should be a compromise with including enough evidence that is relevant, and avoiding over-simplification.
What is a tool for health utility measure?
EQ-5D which is a questionarre to assess quality of life based on:
Mobility
Self-care
Ability to do usual activities
Pain or discomfort
Anxiety or depressoin
What is a tool for population utility measures?
Quality of life adjusted years, used to generate incremental cost-effectiveness ratios, based on 1 year of perfect health= 1 QALY.
What should be performed if a decision analysis is uncertain?
Sensitivity analysis, which looks at the effect that different values will have on the outcome.
What are the benefits of decision analysis?
Makes all the assumptions in decisions explicit
Allows examination of evidence in the decision process
Integrates research evidence into the decision process
Can be used for cost-effectiveness analysis and population level decisions
What are the drawbacks of decision analysis in terms of utility measures?
Patient may be asked to rate a state of health they haven’t experienced
Different techniques used will result in different values
Risk of presentation framing effect, where how information is presented will influence the reaction
What are the limitations of decision analysis in terms of population measures?
Subjective probability estimates are prone to bias
The required data sets to estimate the probability for each branch may not exist
