Premium
Application of statistical decision theory to treatment choices: Implications for the design and analysis of clinical trials
Author(s) -
Simes R. J.
Publication year - 1986
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.4780050505
Subject(s) - decision analysis , decision theory , computer science , strengths and weaknesses , function (biology) , clinical trial , management science , value (mathematics) , statistical analysis , risk analysis (engineering) , medicine , psychology , machine learning , statistics , mathematics , economics , social psychology , pathology , evolutionary biology , biology
This paper explores the application of statistical decision theory to treatment choices in cancer which involve difficult value judgements in weighing beneficial and deleterious outcomes of treatment. Strengths and weaknesses of using decision theory are illustrated by considering the problem of selecting chemotherapy in advanced ovarian cancer. The paper includes an assessment of individual preferences in 27 volunteers and a discussion of some problems in utility assessment. An alternative approach, using threshold analysis, is presented in which the results of the decision analysis are expressed as a function of utility parameters. By knowing what sets of utilities favour each treatment, the assessment of patient preferences can then be focused on important differences of treatment options. The implications of these results for the design and analysis of clinical trials are discussed.