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Decision Analysis in Psychiatry

Published online by Cambridge University Press:  02 January 2018

Simon Hatcher*
Affiliation:
Pupuke Centre, North Shore Hospital, Private Bag 93-503, Takapuna, Auckland 9, New Zealand

Abstract

Background

Decision analysis is an explicit, quantitative approach to examining difficult decisions about course of action. Its applicability to psychiatry is considered.

Method

An example of how decision analysis could be used in psychiatry is given, criticism of the technique is discussed, and previous attempts to apply it to mental illness problems (from a Medline search from 1966 onwards) are reviewed.

Conclusion

The future for decision analysis in psychiatry lies in teaching, audit and research, rather than clinical work.

Type
Review Article
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Brett, A. S. (1981) Hidden ethical issues in decision analysis. The New England Journal of Medicine, 305, 11501152.Google Scholar
Crawford, R. & Forrest, A. (1974) Controlled trial of depot fluphenazine in out-patient schizophrenics. British Journal of Psychiatry, 124, 385391.Google Scholar
Crow, T. J., MacMillan, J. F., Johnson, A. L. & Johnstone, E. C. (1986) A randomised controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry, 148, 120127.Google Scholar
Detsky, A. S. (1987) Decision analysis: what's the prognosis? Annals of Internal Medicine, 106, 321322.CrossRefGoogle ScholarPubMed
Dolan, J. G. (1990) Can decision analysis adequately represent clinical problems? Journal of Clinical Epidemiology, 43, 277284.CrossRefGoogle ScholarPubMed
Falloon, I., Watt, D. C. & Shepherd, M. (1978) A comparative trial of pimozide and fluphenazine decanoate in the continuation therapy of schizophrenia. Psychological Medicine, 8, 5970.Google Scholar
Feinstein, A. R. (1977) Clinical biostatistics XXXIX. The haze of Bayes, the aerial palaces of decision analysis, and the computerised Ouija board. Clinical Pharmacology and Therapeutics, 21, 482496.CrossRefGoogle ScholarPubMed
Greep, J. M. & Siezenis, L. M. (1989) Methods of decision analysis: protocols, decision trees, and algorithms in medicine. World Journal of Surgery, 13, 240244.Google Scholar
Hamm, R. M., Clark, J. A. & Bursztajn, H. (1984) Psychiatrists' thorny judgements. Describing and improving decision making processes. Medical Decision Making, 4, 425447.CrossRefGoogle Scholar
Johnson, D. A. W. & Freeman, H. (1973) Drug defaulting by patients on long-acting phenothiazines. Psychological Medicine, 3, 115119.Google Scholar
Kassirer, J. P., Moskowitz, A. J., Lau, J., et al (1987) Decision analysis: A progress report. Annals of Internal Medicine, 106, 275291.Google Scholar
Littenberg, B. & Sox, H. C. (1988) Evaluating individualized medical decision analysis. The American Journal of Medicine, 84, 289290.CrossRefGoogle ScholarPubMed
McCreadie, R. G., Dingwall, J. M., Wiles, D. H., et al (1980) Intermittent pimozide versus fluphenazine decanoate as maintenance therapy in chronic schizophrenia. British Journal of Psychiatry, 137, 510517.Google Scholar
McNeil, B. J., Pauker, S. G., Sox, H. C., et al (1982) On the elicitation of preferences for alternative therapies. The New England Journal of Medicine, 306, 12591262.Google Scholar
Moore, P. G. & Thomas, H. (1988) The Anatomy of Decisions. London: Penguin.Google Scholar
Nettleman, M. D. (1988) Practical applications of decision analysis. Infection Control and Hospital Epidemiology, 9, 214218.Google Scholar
Plante, D. A., Kassirer, J. P., Zarin, D. A., et al (1986) Clinical decision consultation service. The American Journal of Medicine, 80, 11691176.Google Scholar
Pauker, S. G. & Kassirer, J. P. (1987) Decision analysis. The New England Journal of Medicine, 316, 250258.Google Scholar
Prior, A. (1987) Personal view. British Medical Journal, 295, 920.Google Scholar
Ransohoff, D. F. & Feinstein, A. R. (1976) Is decision analysis useful in clinical medicine? The Yale Journal of Biology and Medicine, 49, 165168.Google Scholar
Sackett, D. L., Haynes, R. B., Guyatt, G. H., et al (1991) Clinical Epidemiology: a Basic Science for Clinical Medicine (2nd edition). Boston: Little, Brown and Co.Google Scholar
Schulberg, H. C., Block, M. R. & Coulehan, J. L. (1989) Treating depression in primary care practice. An application of decision analysis. General Hospital Psychiatry, 11, 208215.Google Scholar
Schwartz, W. B. (1979) Decision analysis. A look at the chief complaints. The New England Journal of Medicine, 300, 556559.Google Scholar
Task Force on Late Neurological Effects of Antipsychotic Drugs (1980) Tardive dyskinesia: a summary of a task force report of the American Psychiatric Association. American Journal of Psychiatry, 137, 11631172.Google Scholar
Thornton, J. G., Lilford, R. J. & Johnson, N. (1992) Decision analysis in medicine. British Medical Journal, 304, 10991103.Google Scholar
Tversky, A. & Kahneman, D. (1974) Judgement under uncertainty: heuristics and biases. Science, 185, 11241131.Google Scholar
Webb, R. K. (1988) Medical decision making and decision analysis. Anaesthesia and Intensive Care, 16, 107109.Google Scholar
Weinstein, M. C. & Fineberg, H. V. (1980) Clinical decision analysis. Philadelphia: W. B. Saunders.Google Scholar
Worrall, E. P. (1989) Consent to treatment and clinical decision analysis. A solution to medical uncertainty and public doubt. Psychiatric Bulletin, 13, 7981.CrossRefGoogle Scholar
Zarin, D. A. & Pass, T. M. (1987) Lithium and the single episode. When to begin long-term prophylaxis for bipolar disorder. Medical Care, 25 (Suppl. 12), S76S84.Google Scholar
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