FOREWORD XVII PREFACE XVIII ABOUT THE COMPANION WEBSITE XX 1 Introduction: Medical Decisions 1 1.1 Introduction 1 1.2 Example of a Medical Decision 2 1.3 Uncertainty in Medical Decisions 9 1.4 Quantifying What the Possible Outcomes Mean to the Patient 13 1.5 Temporal Aspects of Decision Outcomes 22 1.6 Who Is the Decision-Maker? 25 1.7 Epilogue 30 2 Probabilistic Analysis: Quantifying Uncertainty 36 2.

1 Introduction 36 2.2 Basic Principles - Probability as a Measure of Certainty 38 2.3 Bayes'' Formula - An Example of How Probability Is Analyzed 44 2.4 Generalizing Probabilistic Analysis 64 2.5 Expected Value - Summarizing Random Variables 72 2.6 Epilogue 74 3 Decision Trees: Structuring Decision Problems 82 3.1 Introduction 82 3.2 Decision Tree Basics 82 3.

3 Decision Tree Analysis 95 3.4 Leukemia Treatment Decision - A Complete, Detailed Medical Example 101 3.5 Epilogue 112 4 Sensitivity Analysis: Analyzing the Analysis 115 4.1 Introduction 115 4.2 Medical Example - Maintenance Therapy for Acute Myeloid Leukemia 115 4.3 Traditional Sensitivity Analysis 116 4.4 Stochastic Sensitivity Analysis 123 4.5 Epilogue 137 5 Determining Probabilities: Empirical and Subjective Methods 147 5.

1 Introduction 147 5.2 Empirical Probabilities Based on Predictive Models 147 5.3 Subjective Methods 168 5.4 Epilogue 186 6 Survival Models: Representing the Uncertainty About the Length of Life 191 6.1 Introduction 191 6.2 Survival Model Basics 192 6.3 Constant Hazard Rate Survival Models 200 6.4 Actuarial Survival Models 204 6.

5 Fitting Parametric Models to Observations 214 6.6 Epilogue 222 7 Utility Fundamentals: Risk Attitudes and Quantifying Preferences 225 7.1 Introduction 225 7.2 What Are Risk Attitudes? 226 7.3 Demonstration of Risk Attitudes in a Medical Context 227 7.4 Mathematical Foundations 237 7.5 General Observations About Outcome Utilities 243 7.6 More Mathematics 248 7.

7 Determining Outcome Utilities - Underlying Concepts 254 7.8 Epilogue 260 8 Parametric Utility Models: Simplifying the Representation of Risk Attitudes 266 8.1 Introduction 266 8.2 First Example of a Parametric Model for Outcome Utilities 267 8.3 Other Parametric Utility Models 292 8.4 Incorporating Risk Attitudes into Clinical Policies 306 8.5 Epilogue 315 9 Multidimensional Utility Models: Adjusting for the Quality of Life 321 9.1 Introduction 321 9.

2 Example - Why Does the Quality-of-Life Matters? 322 9.3 Quality-Lifetime Tradeoff Models 326 9.4 Quality-Survival Tradeoff Models 336 9.5 Utility Independence 343 9.6 What Does It All Mean? - Utility Assessment and an Extended Example 355 9.7 Epilogue 362 10 Markov Models: Representing the Dynamics of Uncertainty 366 10.1 Introduction 366 10.2 Markov Model Basics 367 10.

3 Analysis of Markov Models - Direct Approach 377 10.4 Nonstationary Markov Models 393 10.5 Epilogue 402 11 Utility for Time-Varying Outcomes: Preferences for When Things Happen 411 11.1 Introduction 411 11.2 Motivating Example and Notation 411 11.3 Willingness-To-Pay Models 416 11.4 The Markovian Utility Model 419 11.5 Example 433 11.

6 Generalizations 440 11.7 Epilogue 447 12 Decision Thresholds: Deciding When to Act 453 12.1 Introduction 453 12.2 Threshold Probability for Treatment 454 12.3 Test Threshold Probabilities for Binary Tests 467 12.4 Test Threshold Probabilities for More Complex Tests 480 12.5 Epilogue 483 13 Receiver Operating Characteristic Curves: Graphical Analysis of Diagnostic Performance 489 13.1 Introduction 489 13.

2 Receiver Operating Characteristic Curve Analysis 491 13.3 Parameterized Cutoff Analysis 505 13.4 Decision Curve Analysis 510 13.5 Accounting for Nondiagnostic Effects 512 13.6 Epilogue 519 14 Influence Diagrams: Scalable Alternative to Decision Trees 526 14.1 Introduction 526 14.2 Influence Diagram Structure 527 14.3 Encoding Uncertainty in an Influence Diagram 530 14.

4 Analyzing an Influence Diagram 532 14.5 Extending Influence Diagrams 537 14.6 Epilogue 543 15 Analyzing Screening Protocols: Predicting How Periodic Testing Affects Patient Outcomes 545 15.1 Introduction 545 15.2 Cervical Cancer 546 15.3 Representing the Natural History of Cervical Cancer 551 15.4 Screening Protocol Analysis 561 15.5 Epilogue 584 16 Monetary Costs: The Elephant in the Exam Room 589 16.

1 Introduction 589 16.2 Cost-Effectiveness and Cost-Benefit Analysis 590 16.3 Shared Resource Analysis 606 16.4 Epilogue 631 Exercises 634 17 Prospect Theory: A Possible Paradigm Shift for Decision Analysis 636 17.1 Introduction 636 17.2 Examples of How Decisions Are Made 636 17.3 Prospect Theory 646 17.4 Framing Decision Problems 654 17.

5 Cumulative Prospect Theory 657 17.6 Assessment of Weighting Functions in a Medical Context 666 17.7 Epilogue 669 INDEX 671.