Decision making in health care involves consideration of a complex set of diagnostic, therapeutic and prognostic uncertainties. Medical therapies have side effects, surgical interventions may lead to complications, and diagnostic tests can produce misleading results. Furthermore, patient values and service costs must be considered. Decisions in clinical and health policy require careful weighing of risks and benefits and are commonly a trade-off of competing objectives: maximizing quality of life vs maximizing life expectancy vs minimizing the resources required. This text takes a proactive, systematic and rational approach to medical decision making. It covers decision trees, Bayesian revision, receiver operating characteristic curves, and cost-effectiveness analysis, as well as advanced topics such as Markov models, microsimulation, probabilistic sensitivity analysis and value of information analysis. It provides an essential resource for trainees and researchers involved in medical decision modelling, evidence-based medicine, clinical epidemiology, comparative effectiveness, public health, health economics, and health technology assessment.
Author Biography:
M. G. Myriam Hunink is Professor of Clinical Epidemiology and Radiology, Departments of Epidemiology and Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands, and Adjunct Professor of Health Decision Sciences, Department of Health Policy and Management, Harvard School of Public Health, Harvard University, Boston, MA, USA. Milton C. Weinstein is the Henry J. Kaiser Professor of Health Policy and Management and Biostatistics at the Harvard School of Public Health, and Professor of Medicine at the Harvard Medical School, Harvard University, Boston, MA, USA. Eve Wittenberg is a Senior Research Scientist at the Center for Health Decision Science, Harvard School of Public Health, Boston, MA, USA. Michael F. Drummond is Professor of Health Economics and former Director of the Centre for Health Economics at the University of York, York, UK. Joseph S. Pliskin is the Sidney Liswood Professor of Health Care Management at Ben-Gurion University of the Negev, Beer-Sheva, Israel, and Adjunct Professor in the Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA. John B. Wong is Chief of the Division of Clinical Decision Making, Tufts Medical Center, and Professor of Medicine, Tufts University School of Medicine, Boston, MA, USA. Paul P. Glasziou is Professor of Evidence-Based Medicine, and Director, Centre for Research in Evidence-Based Practice, Bond University, Australia, and Honorary Professor at the Universities of Oxford and Sydney.
