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Making Decisions When no Further Diagnostic Testing is Available (Expected Regret Theory Threshold Model)

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Threshold Decision-making in Clinical Medicine

Part of the book series: Cancer Treatment and Research ((CTAR,volume 189))

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Abstract

In Chap. 2, we illustrated the application of the expected utility theory (EUT) to rational decision-making when no further diagnostic testing is available. In this chapter, we apply regret theory to the decision problems discussed in Chap. 2.

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Notes

  1. 1.

    This is not always the case; for example, if we assume that the simultaneous occurrence of the effect of disease and the harms of treatment are clinically not negligible (as it was assumed in the derivation of the threshold equation in Chap. 2), then EUT and ERG will generate mathematically different results (see Appendix for technical details).

  2. 2.

    We wish to thank Dr. Alessandro Cucchetti for his help with the DVAS illustration.

References

  1. Djulbegovic B, Elqayam S, Reljic T, Hozo I, Miladinovic B, Tsalatsanis A et al (2014) How do physicians decide to treat: an empirical evaluation of the threshold model. BMC Med Inform Decis Mak 14(1):47

    Article  PubMed  PubMed Central  Google Scholar 

  2. Djulbegovic B, Hamm RM, Mayrhofer T, Hozo I, Van den Ende J (2015) Rationality, practice variation and person-centred health policy: a threshold hypothesis. J Eval Clin Pract 21(6):1121–1124

    Article  PubMed  PubMed Central  Google Scholar 

  3. Djulbegovic B, van den Ende J, Hamm RM, Mayrhofer T, Hozo I, Pauker SG et al (2015) When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation. Eur J Clin Invest 45(5):485–493

    Article  PubMed  Google Scholar 

  4. Djulbegovic B, Elqayam S (2017) Many faces of rationality: Implications of the great rationality debate for clinical decision-making. J Eval Clin Pract 23(5):915–922

    Article  PubMed  PubMed Central  Google Scholar 

  5. Djulbegovic B, Elqayam S, Dale W (2018) Rational decision making in medicine: Implications for overuse and underuse. J Eval Clin Pract 24(3):655–665

    Article  PubMed  Google Scholar 

  6. Djulbegovic B, Frohlich A, Bennett CL (2005) Acting on imperfect evidence: how much regret are we ready to accept? J Clin Oncol 23(28):6822–6825

    Article  PubMed  Google Scholar 

  7. Djulbegovic B, Hozo I, Schwartz A, McMasters K (1999) Acceptable regret in medical decision making. Med Hypotheses 53:253–259

    Article  CAS  PubMed  Google Scholar 

  8. Djulbegovic B, Lyman G (2006) Screening mammography at 40–49 years: regret or regret? Lancet 368:2035–2037

    Article  PubMed  Google Scholar 

  9. Djulbegovic B, Hozo I (2007) When should potentially false research findings be considered acceptable? PLoS Med 4(2):e26

    Article  PubMed  PubMed Central  Google Scholar 

  10. Djulbegovic B, Tsalatsanis A, Mhaskar R, Hozo I, Miladinovic B, Tuch H (2016) Eliciting regret improves decision making at the end of life. Eur J Cancer 68:27–37

    Article  PubMed  Google Scholar 

  11. Djulbegovic B, Beckstead JW, Elqayam S, Reljic T, Hozo I, Kumar A et al (2014) Evaluation of physicians’ cognitive styles. Med Decis Making 34(5):627–637

    Article  PubMed  Google Scholar 

  12. Djulbegovic M, Beckstead J, Elqayam S, Reljic T, Kumar A, Paidas C et al (2015) Thinking styles and regret in physicians. PLoS ONE 10(8):e0134038

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hozo I, Djulbegovic B (2008) When is diagnostic testing inappropriate or irrational? Acceptable regret approach. Med Decis Making 28(4):540–553

    Article  PubMed  Google Scholar 

  14. Hozo I, Djulbegovic B (2009) Will insistence on practicing medicine according to expected utility theory lead to an increase in diagnostic testing? Med Decis Making 29:320–322

    Article  Google Scholar 

  15. Hozo I, Djulbegovic B (2009) Clarification and corrections of acceptable regret model. Med Decis Making 29:323–324

    Google Scholar 

  16. Hozo I, Schell MJ, Djulbegovic B (2008) Decision-making when data and inferences are not conclusive: risk-benefit and acceptable regret approach. Semin Hematol 45(3):150–159

    Article  PubMed  Google Scholar 

  17. Hozo I, Tsalatsanis A, Djulbegovic B (2018) Expected utility versus expected regret theory versions of decision curve analysis do generate different results when treatment effects are taken into account. J Eval Clin Pract 24(1):65–71

    Article  PubMed  Google Scholar 

  18. Mhaskar RS, Reljic T, Wao H, Kumar A, Miladinovic B, Djulbegovic B (2014) Treatment-related harms: what was planned and what was reported? National Cancer Institute’s Co-operative group phase III randomized controlled trials: a systematic review. J Clin Epidemiol 67(3):354–356

    Article  PubMed  Google Scholar 

  19. Schneiderman LJ, Jecker NS, Jonsen AR (1996) Medical futility: response to critiques. Ann Intern Med 125:669–674

    Article  CAS  PubMed  Google Scholar 

  20. Thorsteinsdottir S, Kristinsson SY (2022) The consultant’s guide to smoldering multiple myeloma. Hematology Am Soc Hematol Educ Program 2022(1):551–559

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tsalatsanis A, Barnes LE, Hozo I, Djulbegovic B (2011) Extensions to regret-based decision curve analysis: an application to hospice referral for terminal patients. BMC Med Inform Decis Mak 11:77

    Article  PubMed  PubMed Central  Google Scholar 

  22. Tsalatsanis A, Hozo I, Vickers A, Djulbegovic B (2010) A regret theory approach to decision curve analysis: a novel method for eliciting decision makers’ preferences and decision-making. BMC Med Inform Decis Mak 10(1):51

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tsalatsanis A, Hozo I, Djulbegovic B (2017) Acceptable regret model in the end-of-life setting: patients require high level of certainty before forgoing management recommendations. Eur J Cancer 75:159–166

    Article  PubMed  Google Scholar 

  24. Zeelenberg M, Pieters R (2007) A theory of regret regulation 1.0. J Consumer Psychol 17:3–18

    Google Scholar 

  25. Zeelenberg M, Pieters R (2007) A theory of regret regulation 1.1. J Consumer Psychol 17:29–35

    Google Scholar 

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Correspondence to Benjamin Djulbegovic .

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Djulbegovic, B., Hozo, I. (2023). Making Decisions When no Further Diagnostic Testing is Available (Expected Regret Theory Threshold Model). In: Threshold Decision-making in Clinical Medicine. Cancer Treatment and Research, vol 189. Springer, Cham. https://doi.org/10.1007/978-3-031-37993-2_3

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  • DOI: https://doi.org/10.1007/978-3-031-37993-2_3

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