Implementation of continuous risk utility assessment: The total hip replacement decision

Application or utility theory to medical decision-making problems has received considerable attention in the decision analysis literature but has not led to widespread clinical use. Potential reasons for this stem from the fact that standard preference assessment protocols offer choices that are too...

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Bibliographic Details
Published in:Socio-economic planning sciences 1994-12, Vol.28 (4), p.251-276
Main Authors: Pellissier, James M., Hazen, Gordon B.
Format: Article
Language:English
Subjects:
Decision Making
Hip replacement
Medicine
Risk assessment
Theory
Utility
Utility theories
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Summary:Application or utility theory to medical decision-making problems has received considerable attention in the decision analysis literature but has not led to widespread clinical use. Potential reasons for this stem from the fact that standard preference assessment protocols offer choices that are too simplistic to adequately address a number of medical issues and can result in choices that are unrealistic and unfamiliar to the patient. Continuous risk utility assessment (CRUA) offers an alternative methodology by which more realistic assessment scenarios can be used. However, continuous risk assessment questions can be complex, and issues involving the suitability of CRUA to medical treatment decisions in a clinical setting need to be addressed. This paper describes the use of CRUA in the treatment decision facing a patient with advanced osteoarthritis of the hip. A microcomputer-based implementation of the CRUA protocol is presented, and the results of an evaluation of this protocol arc reported. The study results indicate that CRUA is feasible in a clinical selling and might serve a useful and valuable purpose in the clinical decision-making process.
ISSN:0038-0121
1873-6041
DOI:10.1016/0038-0121(94)90030-2