Decision making in health care involves navigating through a complex and tangled web of diagnostic and therapeutic uncertainties, patient preferences and values, and costs. Medical therapies have side effects, surgery may lead to undesirable complications, and diagnostic technologies may produce inconclusive results. In many clinical and health policy decisions it is necessary to counterbalance benefits and risks, and to trade off competing objectives such as maximizing life expectancy vs optimizing quality of life vs minimizing the resources required. This textbook plots a clear course through these complex and conflicting variables. It clearly explains and illustrates tools for integrating quantitative evidence-based data and subjective outcome values in making clinical and health policy decisions. The book will be of immense practical value for all those charged with the responsibility of decision making in medicine, including practitioners and trainees, and for students studying clinical decision analysis, EB-medicine, and clinical epidemiology.

Table of Contents

Preface; 1. Elements of decision making in health care; 2. Managing uncertainty; 3. Choosing the best treatment; 4. Valuing outcomes; 5. Interpreting diagnostic information; 6. Deciding when to test; 7. Multiple test results; 8. Finding and summarizing the evidence; 9. Constrained resources; 10. Recurring events; 11. Variability and uncertainty; 12. Proactive decision making: a way of life; Index.

Reviews

'This is an impressively comprehensive approach to clinical decision-making with every angle considered, advantages and disadvantages tabulated ... there is a great deal of knowledge and information in these chapters, presented with masses of detailed mathematical and statistical analysis.' Journal of the Royal Society of Medicine '... once I started to read the book, I was gripped. It is very readable, making a complex subject appear crystal clear and easy to understand ... this book is a very useful addition to the literature on evidence-based health care, providing clear strategies for incorporating decision analysis into our daily decision making.' Family Practice 'This book would be a useful acquisition for a statistician who needs the basics of decision-making, and it would certainly be a good book for a non-statistician.' Pharmaceutical Statistics