J.Jpn. Surg. Soc.. 82(1): 108-114, 1981

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Original article

STATISTICAL APPROACH TO OPTIMAL DECISION MAKING IN CLINICAL DIAGNOSIS AND TREATMENT

Statistical approach to optimal decision making under crucial clinical situations was described using the following examples: 1) which is the treatment of choice at a given serum bilirubin level, percutaneous transhepatic biliary catheterization or surgical drainage for a patient with obstructive jaundice (selection of the optimal treatment among many possibilities depending on the patient’s variables), 2) Should surgery be done immediately, or delayed until the diagnosis is established for a jaundiced infant whose findings are in favor of congenital biliary atresia but do not exclude the possibility of neonatal hepatitis (determination of the timing or the type of treatment when the diagnosis is unceatain), and 3) what is the optimal radiation dosis for a given size of skin cancer (estimation of the optimal value of a therapeutic variable or patient’s variables). The probit analysis proved to be of special value in these examples.
The principal role of statistical decision, compared with other conventional forms of decision making such as those based on personal experience, animal experiments or theoretical reasoning was stressed. Also, problems encountered for its application was discussed.

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