ABSTRACT
This chapter aims to introduce the decision analysis model with an easily understood, though simplified, clinical example. Strategies of highest quality are developed with decision analysis when all aspects bearing directly on quality are factored appropriately into the specification of utility. An adjustment that may make expected remaining years of life more nearly reflect utility consists of weighting time periods by corresponding quality-of-life indices to form quality adjusted life years. The selection and optimization of diagnostic tests are important applications for the maximization of quality in medical care. The role of decision analysis in building a framework for quality assessment, as well as in forming guidelines for practice, is discussed by Donabedian. In applications to public health, decision analysis helps reach policy decisions and an understanding of trade-offs in the planning of programs for such activities as screening and immunization.
