Decision analysis: theory and application to medicine

The formal methodology of clinical decision analysis has its origins in probability theory, statistical inference, game theory, and economics. Its application to the arena of problems in medicine and public policy should have a vast impact on the way medicine is practiced in the twenty-first century and beyond. The clinical decision analyses published in journals are based on particular assumptions; if these assumptions do not hold true, the results must be regarded as suspect. However, if the assumptions do hold true or if they reasonably approximate reality, the analyses and results of decision analyses must be appreciated and understood. Their interpretation may yield improved health for patients, monetary savings, or an explicit understanding of the uncertainties that exist and the tradeoffs that must be considered in decision making in primary care.