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Decision Analysis for Healthcare Managers
Farrokh Alemi, PhD
David H. Gustafson, PhD

Chapter 5: Decision Trees
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Companion Items

In question 3 of the Review What You Know section on page 144, $1,250,000 should read $1,055,000.
In question 4 of the Review What You Know section on page 144, 0.44 should read 0.46.
Sample Rapid-Analysis Exercises
B. created a decision tree for the local universal health plan outlined in Option 1
Learning Tools
Listen to a narrated presentation on the components of a decision tree and on folding back a tree and analyzing the data
Watch an animated example on calculating expected costs using Excel
Watch an animated example on analyzing sensitivity of conclusions to changes in a single estimate
Watch an animated example on analyzing sensitivity of conclusions to changes in multiple estimates
Download slides on decision trees
Websites of Interest
List of articles on the use of decision trees
Slides on the use of decision trees in the context of an analysis of insurance rates
Additional Readings
Babic, S. H., P. Kokol, V. Podgorelec, M. Zorman, M. Sproga, and M. M. Stiglic. 2000. “The Art of Building Decision Trees.” Journal of Medical Systems 24 (1): 43–52. This article examines four different approaches to building a decision tree.
Coughlin, M. T., and D. C. Angus. 2003. “Economic Evaluation of New Therapies in Critical Illness.” Critical Care Medicine 31 (1): Suppl. 7–16. The article reviews the application of decision analysis in economic evaluations of new therapies. Elements of a cost-effectiveness analysis are also discussed.
Detsky, A.S., G. Naglie, M. D. Krahn, D. A. Redelmeier, and D. Naimark. 1997. “Primer on Medical Decision Analysis: Part 2—Building a Tree.” Medical Decision Making 17 (2):126–35. This article provides a tutorial on the use of decision trees in analysis of clinical decisions. It is the second part of a five-part series on decision analysis.
Fleisher, L. A., S. Mantha, and M. F. Roizeu. 1998. “Medical Technology Assessment: An Overview.” Anesthesia and Analgesia 87 (6): 1271–82. This article provides advice on how to evaluate the impact of technology on various outcomes. It includes a decision tree for choosing between vascular surgery alone or coronary artery revascularization before vascular surgery.
Grout, J. R. 2003. “Preventing Medical Errors by Designing Benign Failures.” Joint Commission Journal on Quality and Safety 29 (7): 354–62. This article examines the application of fault trees in medicine.
Lovett, L., and D. Seedhouse. 1990. “A Decision Tree for Medical Ethics: An Aid to Assessing Medical Dilemmas.” Humane Medicine 6 (3): 174–9. A novel method of using a decision tree in the context of ethical choices.
Sims, C. J., L. Meyn, R. Caruana, R. B. Rao, T. Mitchell, and M. Krohn. 2000. “Predicting Cesarean Delivery with Decision Tree Models” American Journal of Obstetrics and Gynecology 183 (5): 1198–206. This article shows the use of decision tree in predicting cesarean delivery.
Weiner, W. J. 2002. “An Algorithm (Decision Tree) for the Management of Parkinson's Disease (2001): Treatment Guidelines.” Neurology 58 (1): 156; author reply 156–7. This article makes use of a decision tree for the management of Parkinson’s disease. The article discusses various topics including the management of Parkinson’s disease, including pharmacologic management, the management of motor complications, surgical management, and other related issues.