Università di Pavia - Offerta formativa

MEDICAL DECISION MAKING AND DECISION ANALYSIS

Enrollment year

2020/2021

Academic year

2020/2021

Regulations

DM270

Academic discipline

ING-INF/06 (ELECTRONIC AND INFORMATION BIOENGINEERING)

Department

DEPARTMENT OF ELECTRICAL,COMPUTER AND BIOMEDICAL ENGINEERING

Course

BIOENGINEERING

Curriculum

Sanita' digitale

Year of study

1°

Period

1st semester (28/09/2020 - 22/01/2021)

ECTS

6

Lesson hours

56 lesson hours

Language

Italian

Activity type

WRITTEN AND ORAL TEST

Teacher

QUAGLINI SILVANA (titolare) - 6 ECTS

Prerequisites

Basic knowledge of probability theory is required. For the practical part, a certain familiarity with the use of the PC (Windows) is required.

Learning outcomes

The aim of the course is to provide the methodologies to model complex medical problems, in which decisions are required in the presence of uncertainty and / or taking into account patient preferences and / or multi-attribute utility functions (for example when balancing costs and benefits). Diagnostic, therapeutic and monitoring problems can be treated. At the end of the course, the student must be able to formalize a decision-making problem, identifying the variables of the domain and choosing the most suitable formalisms, both for the purpose of acquiring knowledge (interaction with the medical counterpart for the construction of the model and interaction with the patient for the elicitation of preferences), and for the purpose of solving the problem. Among the classes of decision-making problems, particular emphasis will be given to the economic evaluations prior to the decision on whether or not to start a health program. Ample space will also be given to the practical use of IT tools for the resolution of decision-making models.

Course contents

1. Introduction: uncertainty and preferences as fundamentals of decision problems

2. Brief review of the basic concepts of probability theory

to. some probabilities of fundamental importance in medicine

b. Bayes' theorem and its use in diagnostics

c. probabilistic networks

d. use of software for probabilistic networks

3. The decision theory :

to. quantification of the value of an outcome (state of health)

b. methods for the quantification of utilities (standard gamble, time-trade-off, rating scale)

c. utility waiting for a decision

d. probabilistic dominance of one strategy over the other possible ones

4. Decision trees

a. methodologies for construction and resolution

b. use of a software for the management of decision trees

c. sensitivity and threshold analysis, univariate and multivariate

d. representation of Markov processes within a decision tree

5. Influence diagrams

to. methodologies for construction and resolution

b. use of software for influence diagrams

6. Economic evaluations of health programs

to. cost-effectiveness, cost-benefit, cost-utility analysis

b. Reference thresholds for cost / effectiveness ratios

c. critical reading of a literature article on the subject

2. Brief review of the basic concepts of probability theory

to. some probabilities of fundamental importance in medicine

b. Bayes' theorem and its use in diagnostics

c. probabilistic networks

d. use of software for probabilistic networks

3. The decision theory :

to. quantification of the value of an outcome (state of health)

b. methods for the quantification of utilities (standard gamble, time-trade-off, rating scale)

c. utility waiting for a decision

d. probabilistic dominance of one strategy over the other possible ones

4. Decision trees

a. methodologies for construction and resolution

b. use of a software for the management of decision trees

c. sensitivity and threshold analysis, univariate and multivariate

d. representation of Markov processes within a decision tree

5. Influence diagrams

to. methodologies for construction and resolution

b. use of software for influence diagrams

6. Economic evaluations of health programs

to. cost-effectiveness, cost-benefit, cost-utility analysis

b. Reference thresholds for cost / effectiveness ratios

c. critical reading of a literature article on the subject

Teaching methods

lectures and computer exercises with Genie software for probabilitic networks and TreeAge Pro Healthcare for decision trees

Reccomended or required readings

M.C. Weinstein, H.V. Fineberg Lâ€™analisi della decisione in medicina clinica, F. Angeli Editore, 2008

R. Tarricone, Valutazioni economiche e management in sanitÃ . Applicazioni ai programmi e tecnologie sanitarie, Milano, McGraw-Hill, 2004.

Course notes in Italian are also available

R. Tarricone, Valutazioni economiche e management in sanitÃ . Applicazioni ai programmi e tecnologie sanitarie, Milano, McGraw-Hill, 2004.

Course notes in Italian are also available

Assessment methods

1- practical test: carrying out a decision tree exercise on the computer

2- oral exam: questions on all the topics of the course

2- oral exam: questions on all the topics of the course

Further information

Sustainable development goals - Agenda 2030