Decision analysis for the practicing gastroenterologist. 2. Insights into the efficacy of diagnostic strategies using...

Decision analysis is a valuable tool for studying diagnostic strategies in gastroenterology. Multiple comprehensive patient management strategies can be compared in hypothetical populations of patients with varying characteristics reflecting real clinical situations which could not be readily empirically studied. Measures of clinical outcome can be compared and cost effectiveness ratios calculated. Analyses of the diagnostic approaches to suspected obstructive jaundice and pancreatic cancer presenting as abdominal pain are discussed as examples. A useful decision analysis combines the best data available in a clinically relevant fashion. Although decision analysis cannot replace empiric research, it helps clarify reasons for the uncertainty so common in clinical practice and provides insight into the diagnostic process that might otherwise be elusive.