Decision trees and prescriber choices

Prescriber decisions are increasingly being pressured by a supply of economic information in the form of cost-effectivenessstudies, or similar evaluations, of a range of pharmaceuticals. These have been welcomed by Virginia Bottomley and a set of guidelines for these studies has been drawn up by the Department of Health and the pharmaceutical industry. Such economic studies are now being published in a wide range of journals and are increasingly being used in promotional literature and publicity handouts by the pharmaceutical companies. Many of these studies are using decision trees with which to represent clinical problems and perform analysis of the costs of treatment. This paper reviews the principles and practice of analysis using these techniques, providing guidance on the critical review of such studies