A pitfall in utility assessment--patients' undisclosed investment decisions. |
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Authors: | J Hilden P P Glasziou J D Habbema |
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Institution: | Institute of Medical Genetics (Biostatistics), University of Copenhagen, Denmark. |
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Abstract: | Among those decisions that may be made by a patient in response to an illness, the authors single out a certain class: contingent investment decisions. They are characterized by the patient's committing him- or herself, on the basis of prognostic counseling, to a certain action or non-action that he or she may regret in retrospect. Examples show that, when assessing utilities, the decision analyst runs a risk of handling such investment decisions incorrectly, unless they are made explicit and incorporated into the medical decision process. The anomaly is explained as a violation of the structural rules for decision trees and is also interpreted in terms of "the price of prognostic ignorance," a quantity closely related to the expected utility value of perfect information. |
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