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Guide to Statistics and Methods
January 29, 2020

Practical Guide to Decision Analysis

Author Affiliations
  • 1Department of Surgery, Johns Hopkins University, Baltimore, Maryland
  • 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 3Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado
  • 4Department of Emergency Medicine, University of Colorado School of Medicine, Aurora
  • 5Department of Epidemiology, Colorado School of Public Health, Aurora
  • 6Department of Surgery, The Ohio State University Wexner Medical Center, Columbus
JAMA Surg. Published online January 29, 2020. doi:10.1001/jamasurg.2019.5377

Surgical patients and clinicians are often faced with the challenge of choosing between a surgical or medical approach to a disease or choosing between 2 available surgical approaches (often one more invasive than the other). In transplant surgery, these decisions can be particularly challenging in the context of deciding whether to accept an organ offer or wait for a better offer. Decision analysis seeks to inform these challenging decisions in a data-driven manner, ranging from simple observational comparisons among available options1 to sophisticated stochastic decision process models (Markov models) that integrate multiple data sources to evaluate scenarios that have not yet been (adequately) observed.2 Ultimately, these strategies facilitate the development of data-driven tools that can hopefully assist in the shared decision-making process between patients and their clinicians (examples: http://www.transplantmodels.com).

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