A Pitfall in Utility Assessment Patients’ Undisclosed Investment Decisions

Jϕrgen Hilden*, Paul P. Glasziou, J. Dik F. Habbema

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


Among those decisions that may be made by a patient in response to an illness, the authors single out a certain class. contingent investment decisions. They are characterized by the patient's committing him- or herself, on the basis of prognostic counseling, to a certain action or non-action that he or she may regret in retrospect Examples show that, when assessing utilities, the decision analyst runs a risk of handling such investment decisions incorrectly, unless they are made explicit and incorporated into the medical decision process. The anomaly is explained as a violation of the structural rules for decision trees and is also interpreted in terms of “the price of prognostic ignorance,” a quantity closely related to the expected utility value of perfect information. Key words: decision theory; physician-patient relations, patient compliance; prognosis; risk-taking, quality of life; utility theory; patients’ decisions, decision trees. (Med Decis Making 1992;12:39-43)

Original languageEnglish
Pages (from-to)39-43
Number of pages5
JournalMedical Decision Making
Issue number1
Publication statusPublished - Feb 1992
Externally publishedYes


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