A Graphical Decision-Theoretic Model for Neonatal Jaundice
Manuel Gómez,
Concha Bielza,
Juan A. Fernández del Pozo and
Sixto RÃos-Insua
Additional contact information
Manuel Gómez: Decision Analayis and Statistics Group, School of Computer Science, Technical University of Madrid, Spain
Concha Bielza: Decision Analayis and Statistics Group, School of Computer Science, Technical University of Madrid, Spain, mcbielza@fi.upm.es
Juan A. Fernández del Pozo: Decision Analayis and Statistics Group, School of Computer Science, Technical University of Madrid, Spain
Sixto RÃos-Insua: Decision Analayis and Statistics Group, School of Computer Science, Technical University of Madrid, Spain
Medical Decision Making, 2007, vol. 27, issue 3, 250-265
Abstract:
Background. Neonatal jaundice is treated daily at all hospitals. However, the routine, urgency, and case load of most doctors stop them from carefully analyzing all the factors that they would like to (and should) take into account. This article develops a complex decision support system for neonatal jaundice management. Methods. The problem is represented by means of an influence diagram, including admission and treatment decisions. The corresponding uncertainty model is built with the aid of both historical data and subjective judgments. Parents and doctors were interviewed to elicit a multiattribute utility function. The decision analysis cycle is completed with sensitivity analyses and explanations of the results. Results. The construction and use of this decision support system for jaundice management have induced a profound change in daily medical practice, avoiding aggressive treatments—there have been no exchange transfusions in the past 3 years—and reducing the lengths of stay at the hospital. More information is now taken into account to decide on treatments. Interestingly, after embarking on this modeling effort, physicians came to view jaundice as a much more difficult problem than they had initially thought. Comparisons between real cases and system proposals revealed that treatments by nonexpert doctors tend to be longer than what expert doctors would administer. Conclusion. The system is especially designed to help neonatologists in situations in which their lack of experience may lead to unnecessary treatments. Different points of view from several expert doctors and, more interestingly, from parents are taken into account. This knowledge gives a broader picture of the medical problem— incorporating new action criteria, new agents to intervene, more uncertainty variables—to get an insight into the suitability of each therapeutic decision for each patient situation. The benefits gained and the usefulness perceived by neonatologists are worth the increased and time-consuming effort of developing this complex system. Although specially designed for a specific hospital and for neonatal jaundice management, it can be easily adapted to other hospitals and problems.
Keywords: neonatal jaundice; decision analysis; decision making; clinical decision support systems; influence diagrams; multiattribute utilities; socioeconomic factors. (search for similar items in EconPapers)
Date: 2007
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)
Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X07300605 (text/html)
Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
HTML/Text
Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:27:y:2007:i:3:p:250-265
DOI: 10.1177/0272989X07300605
Access Statistics for this article
More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().