Tutorial: How to Perform a Decision Analysis Primer on Medical Decision Analysis: Part 1—Getting Started

This paper is Part 1 of a five-part series covering practical issues in the performance of decision analysis. The intended audience is individuals who are learning how to perform decision analyses, not just read them. The series assumes familiarity with the basic concepts of decision analysis. It imparts many of the recommendations the au-thors have learned in teaching a one-semester course in decision analysis to graduate students. Part 1 introduces the topic and covers questions such as choosing an ap-propriate question, determining the tradeoff between accuracy and simplicity, and de-ciding on a time frame. Key words: decision analysis; expected value; utility; sensitivity analysis; decision trees; probability. (Med Decis Making 1997;17:123-125) Over the past ten years, our group at the University of Toronto has taught a one-semester course on de-cision analysis. Unlike educational initiatives that solely focus on readings about and discussions of decision analysis, our course has required that each student perform a decision analysis. This requires building a decision tree on paper, modeling that tree on a computer, obtaining probabilities and utilities by direct measurement or literature review, evalu-ating the tree, performing sensitivity analyses, pre-senting the study to peers, and writing up the anal-ysis. Several of the students have gone on to publish their work.1-s To pass the course, each student is required to develop a model that &dquo;works.&dquo; In this series9-&dquo; and the accompanying note on presentation, 14 we attempt to impart what we, as teachers, have learned about the practical issues of performing decision analysis. Much of what we hav