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February 14, 1977

Decision Analysis

Author Affiliations

Washington University St Louis

JAMA. 1977;237(7):642. doi:10.1001/jama.1977.03270340027007

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To the Editor.—  The medical profession seems increasingly appreciative of the potential of decision analysis as an aid in complex diagnosis and treatment problems. Decision analysis provides a powerful formal framework for combining subjective and statistical data, clinical judgment, laboratory test results, and patients' and other actors' attitudes toward risk in an analytical search for the best source of action in a given case. It is consistent with the rules of inductive reasoning, and accordingly assigns the proper value to new evidence. It can be effective in an inter active mode, case by case, if an online computer terminal is available, or it can be used to develop guidelines for selecting care strategies which physicians can internalize and employ independently.I have two remarks regarding the first example by Sisson and co-workers. First, I note that some of the numbers at the tips of the tree (Fig 1) on the