Decision Analysis: A Basic Clinical Skill?

Abstract

The Medical Progress article by Pauker and Kassirer in this issue describes advances in applying the principles of decision analysis to patient care.¹ Some problems remain and deserve comment.Decision analysis is a logically consistent approach to a common clinical problem: a decision whose consequences cannot be foretold with certainty. The uncertainties in medical practice stem from biologic variation and the inadequacies of clinical data. Uncertainty is intrinsic to the practice of medicine and cannot be eliminated by any analytical technique, however powerful. Decision analysis claims to identify the best decision, given the constraints imposed by uncertainty. This claim, valid . . .