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The potential use of decision analysis to support shared decision making in the face of uncertainty: The example of atrial fibrillation and warfarin anticoagulation

Lookup NU author(s): Angela Robinson, Emeritus Professor Richard Thomson

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Abstract

The quality of patient care is dependent upon the quality of the multitude of decisions that are made daily in clinical practice. Increasingly, modern health care is seeking to pursue better decisions (including an emphasis on evidence-based practice) and to engage patients more in decisions on their care. However, many treatment decisions are made in the face of clinical uncertainty and may be critically dependent upon patient preferences. This has led to attempts to develop decision support tools that enable patients and clinicians to make better decisions. One approach that may be of value is decision analysis, which seeks to create a rational framework for evaluating complex medical decisions and to provide a systematic way of integrating potential outcomes with probabilistic information such as that generated by randomised controlled trials of interventions. This paper describes decision analysis and discusses the potential of this approach with reference to the clinical decision as to whether to treat patients in atrial fibrillation with warfarin tO reduce their risk of stroke.

Publication metadata

Author(s): Robinson A, Thomson RG

Publication type: Review

Publication status: Published

Journal: Quality in Health Care

Year: 2000

Volume: 9

Issue: 4

Pages: 238-244

Print publication date: 01/01/2000

ISSN (print): 0963-8172

ISSN (electronic): 1470-7934

URL: http://dx.doi.org/10.1136/qhc.9.4.238

DOI: 10.1136/qhc.9.4.238

PubMed id: 11101709

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