Introduction

Decision analysis grew out of economic work on game theory in the 1920’s by Von Neumann.  It was first proposed as a method for medical research by Lee Lusted in 1959, and first applied by Henschke and Flehinger in 1967.  Since then the method has gained momentum, including formation of the Society for Medical Decision-Making.  The latter, while certainly not exclusively devoted to decision analysis, has played an important role in developing its theory and application.

One way to think about decision analysis is that it is a kind of “thought experiment”.  Instead of having to do a randomized controlled trial, which is messy, expensive, and time-consuming, it is possible to simulate the trial using decision analysis.  However, not every decision is worth all this effort.  Decision analysis is most helpful for important, complex, non-urgent, and high-stakes decisions that involve uncertainty.