Heterogeneous uncertainties in cholesterol management

Yakov Ben-Haim, Clifford C. Dacso, Jonathon Carrasco, Nithin Rajan

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Physicians use clinical guidelines to inform judgment about therapy. Clinical guidelines do not address three important uncertainties: (1) uncertain relevance of tested populations to the individual patient, (2) the patient's uncertain preferences among possible outcomes, and (3) uncertain subjective and financial costs of intervention. Unreliable probabilistic information is available for some of these uncertainties; no probabilities are available for others. The uncertainties are in the values of parameters and in the shapes of functions. We explore the usefulness of info-gap decision theory in patient-physician decision making in managing cholesterol level using clinical guidelines. Info-gap models of uncertainty provide versatile tools for quantifying diverse uncertainties. Info-gap theory provides two decision functions for evaluating alternative therapies. The robustness function assesses the confidence-in light of uncertainties-in attaining acceptable outcomes. The opportuneness function assesses the potential for better-than-anticipated outcomes. Both functions assist in forming preferences among alternatives. Hypothetical case studies demonstrate that decisions using the guidelines and based on best estimates of the expected utility are sometimes, but not always, consistent with robustness and opportuneness analyses. The info-gap analysis provides guidance when judgment suggests that a deviation from the guidelines would be productive. Finally, analysis of uncertainty can help resolve ambiguous situations.

Original languageEnglish (US)
Pages (from-to)1046-1065
Number of pages20
JournalInternational Journal of Approximate Reasoning
Volume50
Issue number7
DOIs
StatePublished - Jul 2009
Externally publishedYes

Fingerprint

Cholesterol
Uncertainty
Clinical Guidelines
Therapy
Robustness
Decision Theory
Decision theory
Alternatives
Expected Utility
Ambiguous
Confidence
Guidance
Resolve
Deviation
Decision making
Decision Making
Costs
Estimate
Demonstrate

Keywords

  • Cholesterol management
  • Clinical guidelines
  • Info-gap decision theory
  • Judgment under uncertainty
  • Patient satisfaction

ASJC Scopus subject areas

  • Artificial Intelligence
  • Software
  • Theoretical Computer Science
  • Applied Mathematics

Cite this

Heterogeneous uncertainties in cholesterol management. / Ben-Haim, Yakov; Dacso, Clifford C.; Carrasco, Jonathon; Rajan, Nithin.

In: International Journal of Approximate Reasoning, Vol. 50, No. 7, 07.2009, p. 1046-1065.

Research output: Contribution to journalArticle

Ben-Haim, Yakov ; Dacso, Clifford C. ; Carrasco, Jonathon ; Rajan, Nithin. / Heterogeneous uncertainties in cholesterol management. In: International Journal of Approximate Reasoning. 2009 ; Vol. 50, No. 7. pp. 1046-1065.
@article{36d0a14452fb494a9b5f92c85a6ce981,
title = "Heterogeneous uncertainties in cholesterol management",
abstract = "Physicians use clinical guidelines to inform judgment about therapy. Clinical guidelines do not address three important uncertainties: (1) uncertain relevance of tested populations to the individual patient, (2) the patient's uncertain preferences among possible outcomes, and (3) uncertain subjective and financial costs of intervention. Unreliable probabilistic information is available for some of these uncertainties; no probabilities are available for others. The uncertainties are in the values of parameters and in the shapes of functions. We explore the usefulness of info-gap decision theory in patient-physician decision making in managing cholesterol level using clinical guidelines. Info-gap models of uncertainty provide versatile tools for quantifying diverse uncertainties. Info-gap theory provides two decision functions for evaluating alternative therapies. The robustness function assesses the confidence-in light of uncertainties-in attaining acceptable outcomes. The opportuneness function assesses the potential for better-than-anticipated outcomes. Both functions assist in forming preferences among alternatives. Hypothetical case studies demonstrate that decisions using the guidelines and based on best estimates of the expected utility are sometimes, but not always, consistent with robustness and opportuneness analyses. The info-gap analysis provides guidance when judgment suggests that a deviation from the guidelines would be productive. Finally, analysis of uncertainty can help resolve ambiguous situations.",
keywords = "Cholesterol management, Clinical guidelines, Info-gap decision theory, Judgment under uncertainty, Patient satisfaction",
author = "Yakov Ben-Haim and Dacso, {Clifford C.} and Jonathon Carrasco and Nithin Rajan",
year = "2009",
month = "7",
doi = "10.1016/j.ijar.2009.04.002",
language = "English (US)",
volume = "50",
pages = "1046--1065",
journal = "International Journal of Approximate Reasoning",
issn = "0888-613X",
publisher = "Elsevier Inc.",
number = "7",

}

TY - JOUR

T1 - Heterogeneous uncertainties in cholesterol management

AU - Ben-Haim, Yakov

AU - Dacso, Clifford C.

AU - Carrasco, Jonathon

AU - Rajan, Nithin

PY - 2009/7

Y1 - 2009/7

N2 - Physicians use clinical guidelines to inform judgment about therapy. Clinical guidelines do not address three important uncertainties: (1) uncertain relevance of tested populations to the individual patient, (2) the patient's uncertain preferences among possible outcomes, and (3) uncertain subjective and financial costs of intervention. Unreliable probabilistic information is available for some of these uncertainties; no probabilities are available for others. The uncertainties are in the values of parameters and in the shapes of functions. We explore the usefulness of info-gap decision theory in patient-physician decision making in managing cholesterol level using clinical guidelines. Info-gap models of uncertainty provide versatile tools for quantifying diverse uncertainties. Info-gap theory provides two decision functions for evaluating alternative therapies. The robustness function assesses the confidence-in light of uncertainties-in attaining acceptable outcomes. The opportuneness function assesses the potential for better-than-anticipated outcomes. Both functions assist in forming preferences among alternatives. Hypothetical case studies demonstrate that decisions using the guidelines and based on best estimates of the expected utility are sometimes, but not always, consistent with robustness and opportuneness analyses. The info-gap analysis provides guidance when judgment suggests that a deviation from the guidelines would be productive. Finally, analysis of uncertainty can help resolve ambiguous situations.

AB - Physicians use clinical guidelines to inform judgment about therapy. Clinical guidelines do not address three important uncertainties: (1) uncertain relevance of tested populations to the individual patient, (2) the patient's uncertain preferences among possible outcomes, and (3) uncertain subjective and financial costs of intervention. Unreliable probabilistic information is available for some of these uncertainties; no probabilities are available for others. The uncertainties are in the values of parameters and in the shapes of functions. We explore the usefulness of info-gap decision theory in patient-physician decision making in managing cholesterol level using clinical guidelines. Info-gap models of uncertainty provide versatile tools for quantifying diverse uncertainties. Info-gap theory provides two decision functions for evaluating alternative therapies. The robustness function assesses the confidence-in light of uncertainties-in attaining acceptable outcomes. The opportuneness function assesses the potential for better-than-anticipated outcomes. Both functions assist in forming preferences among alternatives. Hypothetical case studies demonstrate that decisions using the guidelines and based on best estimates of the expected utility are sometimes, but not always, consistent with robustness and opportuneness analyses. The info-gap analysis provides guidance when judgment suggests that a deviation from the guidelines would be productive. Finally, analysis of uncertainty can help resolve ambiguous situations.

KW - Cholesterol management

KW - Clinical guidelines

KW - Info-gap decision theory

KW - Judgment under uncertainty

KW - Patient satisfaction

UR - http://www.scopus.com/inward/record.url?scp=67549127093&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67549127093&partnerID=8YFLogxK

U2 - 10.1016/j.ijar.2009.04.002

DO - 10.1016/j.ijar.2009.04.002

M3 - Article

VL - 50

SP - 1046

EP - 1065

JO - International Journal of Approximate Reasoning

JF - International Journal of Approximate Reasoning

SN - 0888-613X

IS - 7

ER -